Preamble

The House met at half-past Nine o'clock

PRAYERS

[MADAM SPEAKER in the Chair]

PETITIONS

Genetically Modified Food

Mrs. Cheryl Gillan: I should like to present the petition of my young constituent Jake Steel, aged nine, and others.
The petition declares:
The introduction of GM food would have a disastrous effect on the environment and be a health hazard. The Petitioner therefore requests that the House of Commons urges the Ministry of Agriculture, Fisheries and Food to call for a ban on all Genetically Modified Foods and Crops in the United Kingdom and for a thorough independent investigation into GM foods.
I should like to present two other petitions. The first is from one of my constituents, Mrs. Louise Bradbury, Healthright, Holland and Barrett, and others on the classification of health products by the Medicines Control Agency.
The final petition is the humble petition of Rodney Howlett, on European matters.

To lie upon the Table.

Drugs

Motion made, and Question proposed, That this House do now adjourn.—[Mr. Betts.]

The Minister for the Cabinet Office (Dr. Jack Cunningham): I am pleased to open this debate on drug misuse. The misuse of drugs is a matter of great concern to many of us, and to our constituents and their families, who suffer the consequences.
The Government are determined actively to tackle drugs misuse. In our first year, we appointed Keith Hellawell as the United Kingdom anti-drugs co-ordinator to give coherence to drug-related policy making across all Departments. Last year, we published a White Paper, "Tackling Drugs to Build a Better Britain", which sets out our 10-year strategy to reduce drug misuse, and the consequences of drug misuse for society.
The strategy acknowledges, for the first time, the link between drug misuse and social conditions, and the need to tackle the whole range of social problems. The strategy sets targets—based on evidence and experience—for reducing drug misuse, and combines a commitment to firm enforcement with programmes enabling offenders to tackle their drug problems. It also focuses new money on treatment programmes that work, and new ways of getting those with drug problems in touch with those operating the programmes.
Last month, I announced to the House the publication of the United Kingdom anti-drugs co-ordinator's first annual report and national plan. We are now moving into the most vital stage of the process: delivering results. I do not delude myself that that will be an easy task, but I am confident that we can succeed. My confidence stems from the knowledge that we have laid firm foundations upon which we can build and develop the programmes.
The key principles of our strategy are integrated policy making based firmly on evidence; an increased focus on outcomes, with objectives; and better accountability and evaluation mechanisms to ensure that progress is monitored effectively.
Following on from the strategy, the public service agreement on drugs binds all relevant Government Departments to work together to deliver a reduction in the proportion of people under 25 misusing illegal drugs; a reduction in the level of re-offending by drug-misusing offenders; an increase in participation of problem drugs misusers, including prisoners, in drug treatment programmes, which have a positive impact on health and in reducing crime; and a reduction in access to drugs for young people.
We shall also play our part in supporting global actions that seek to reduce not only the supply of drugs, but the demand for drugs. We are helping to take forward the agreements reached, in June 1998, at the United Nations General Assembly special session in New York.
We had to ensure that our strategy's framework for action was backed up by appropriate resources. Therefore, as part of the comprehensive spending review, an additional £217 million has been made available across Government.
As I announced in the House last month, further support for the strategy will be provided by channelling the assets seized from convicted drug dealers back into


action against those people and against drugs. The sum, £3 million this year, should rise to £5 million in the subsequent financial year, and to £7 million in the following year, bringing an additional £15 million—perhaps more; who knows—in that three-year period to bear in our action against drug traffickers and drug dealers.
With the strategic vision in place, and resources allocated to support it, the next step was to set targets—which I acknowledge are hard targets—challenging all of us to redouble our efforts to fight drugs problems. Keith Hellawell's first annual report and national plan did just that—setting targets for the short, medium and long term.
For the first time, Departments and agencies, nationally and locally, are being brought together to work in partnership towards joint performance targets. The focus is very much on results and working together. Between now and 2002, all departmental and agency resources and activities against drugs will increasingly be redirected towards those and associated targets, as provided in the national plan.
Co-ordination of the efforts of national Departments and agencies is essential, but no less vital is the role of drug action teams in co-ordinating local activities. I am sure that others here today would join me in paying tribute to the work of drug action team members and co-ordinators across the country. They are an essential part of the fight against drug misuse. Ultimately, the success of our strategy will depend on the success of drug action teams in addressing the specific drug problems in their areas.
This year, for the first time, an audit has been undertaken of the work of drug action teams across the country, with reports to the UK anti-drugs co-ordinator using a common template. This showed that there is a great deal of activity already under way. It showed also that there is a clear need to provide further support and advice to drug action teams.
To this end, the Government established the new drug prevention advisory service, which has officers in every region of the country. The advisory service will be an additional resource which teams can draw on as they go about what we all acknowledge is a difficult task.
When I announced the publication of the co-ordinator's report and plan, some Members expressed doubts about whether the course that we had chosen would, or could, work. One concern that was expressed was that our targets were unmeasurable because we did not have comprehensive and robust data. That is an important point. We all recognise that we could do with better, more robust and more comprehensive data.
The Government are determined to rectify that situation. That is why we shall be spending an extra £6 million over the next three years to help fund a major new research programme to establish accurate baselines and to evaluate programmes of activity. We need more knowledge and understanding of what is happening on our streets and in our communities.
We are putting in place better information systems to show more definitely what the drug problems are, what works best against them and what is cost-effective. The research programme will establish the hard baselines

against which we can better measure our progress and success. I firmly believe that we can succeed in reducing drug use. There is some evidence that the action that we are pursuing is having a positive impact.
Members will be aware of the national treatment outcome research study—usually known as NTORS—which is one of the biggest surveys of its kind in the world. The study follows the lives of 1,100 drug misusers. My right hon. Friend the Minister for Public Health recently announced the findings of the two-year follow-up study on a group of long-term, severely dependent users of heroin and other drugs, who were treated in residential and community-based settings.
This group had a range of social and other problems, both psychological and physical, and extremely high rates of criminal behaviour. Early findings, based on a follow-up at six months and one year, showed that many of them had achieved substantial reductions in substance misuse and improvements in other problem behaviours.
At two years, those early improvements have been substantially maintained. For example, abstinence rates for heroin have more than doubled, and fewer were injecting drugs or sharing needles. There were also marked reductions in the users' criminal activity. Extremely high rates of criminal behaviour prevailed among the clients prior to entering treatment. The figures are quite staggering—70,000 offences in the previous three months from a group of 1,075. However, after two years, the rate of acquisitive crime more than halved and involvement in drug selling had been substantially reduced. Those who gave up heroin were 10 times more likely to have avoided criminality than those who did not.
These improvements in terms of drug-taking behaviour, health and criminal activity are significant, especially considering the chronic nature of the problems previously experienced by those involved in the study. It is essential that we quantify the benefits of treatment, not only to the individual, but to society as a whole. NTORS has previously shown that for every £1 we spend on drug treatment, we save at least £3—mainly in reduced demand on the criminal justice system. That is why, as part of the strategy, we are investing so much effort and resources in getting drug-misusing offenders into treatment.

Mrs. Jacqui Lait: Was everyone who participated in the NTORS study a volunteer—not only for the study, but for the treatment? Was there a degree of coercion for some?

Dr. Cunningham: They were volunteers—none of this was compulsory to the best of my knowledge. However, it makes no difference. The results speak for themselves, regardless of whether the participants were volunteers for the whole programme or just a part of it. When we can persuade people to go voluntarily into treatment that they can stick with, their behaviour and their health improve dramatically and there are significant benefits for society, as well. I can let the hon. Lady have all the details of the NTORS study if she has not already had a chance to look at them.

Mr. Paul Flynn: In spite of these figures, will my right hon. Friend recall that the most recent judgment by the European drug monitoring service is that drug abuse in Britain is up to five times higher than


other European countries, and is by far the worst in Europe? In other countries, half the drug addicts are in treatment. What percentage of drug addicts are in treatment in this country, and how many will be in treatment in 10 years' time?

Dr. Cunningham: I am aware of the study, and I know that other countries claim to have much higher percentages of people in treatment than we do, although there is some dispute about some of the numbers. However, only a tiny percentage of drug misusers in this country are in treatment. That is the stark reality. On our best estimates, we can say that there are somewhere between 100,000 and 200,000 serious drug misusers in the country. When we look at the numbers who are currently in treatment, we can see that it is a tiny proportion. It is for that reason, among others, that the Government have changed strategy. We will continuously move resources away from simply dealing with the consequences into treatment, education, information and advice. That is the way forward. If my hon. Friend is saying that we have to make greater efforts to get people into treatment, he is right, and I agree with him. I am happy that at least on one aspect of these policy issues we are in some agreement.
Arrest referral schemes provide an excellent way of enabling drug-misusing offenders to obtain help and treatment early. The success of NTORS, which exemplifies our evidence-based approach, is being replicated through many arrest referral schemes and other criminal justice interventions in drug action team areas around the country.
Independent evaluations of Home Office drug prevention initiative demonstration projects provide good evidence that properly constructed arrest referral schemes can have a major impact on drug use—and, therefore, on crime.

Mrs. Ann Winterton: How many police authorities have introduced arrest referral schemes so far? Has there been any independent evaluation of the impact of these schemes on reoffending rates?

Dr. Cunningham: I do not have the exact figure at my fingertips, but the objective is to have suites for referral in all the main centres as quickly as possible. I will ask my colleagues at the Home Office to give the hon. Lady the details. We believe that there is considerable potential for improvement and I hope that, before too long, we will be able to make further announcements about how we intend to develop the work.
The average weekly expenditure on drugs of those picked up by the schemes—this is also very illuminative—was £400 before their contact with the scheme. In almost all cases, that was financed by criminal behaviour. The top three methods of raising the money were shoplifting, selling drugs and burglary. After arrest referral and treatment, average expenditure fell to £95 a week—a 75 per cent. reduction—with corresponding reductions in the use of drugs, especially heroin and cocaine or crack, and in drug-related crime.
Similar results are being reported in other schemes, as we know from drug action teams' reports. That is why we plan to double the number of arrest referral schemes this year, and we have set ourselves a target of ensuring that 100 per cent. of custody suites are covered by arrest referral schemes by 2002.
The Home Office will issue guidance on good practice in setting up arrest referral schemes and other intervention programmes in the criminal justice system this summer. There will also be a significant expansion of probation and court referral schemes in line with the emerging evidence of the drug treatment and testing order pilots and other studies.
Of course, there is no point in reducing the number of drug misusers if more are being created by the dealers who plague our communities. We must concentrate our efforts on prevention as well as cure. Drug education is central to our strategy and evidence is mounting that appropriate drug education helps children to build up the skills and confidence that they need to resist drugs. A recent report by the drugs prevention advisory service strongly suggests that life skills programmes in primary schools can delay or prevent the onset of smoking and drug use.

Mrs. Cheryl Gillan: Has the Minister visited any of the education schemes, and in particular is he aware of the DARE—drug abuse resistance education—scheme which was in operation in Nottingham when I was a junior Minister in the Department for Education and Employment, and which has proved extremely successful?

Dr. Cunningham: On the first part of the question, yes, I have visited such a scheme. I went to a school in Camden with Keith Hellawell to have a look at how it was working in practice and to talk to the young people and staff. We also know about the DARE scheme, which has had significant successes. My hon. Friend the Parliamentary Secretary, Cabinet Office has visited the scheme, but that was before the general election. We are kept in touch with its progress by a significant number of both Government and Opposition Members, who continue to recommend it highly to us. I congratulate those involved on the good work that is being done.

Mr. Flynn: Will my right hon. Friend give way?

Dr. Cunningham: I will give way one more time, but I do not want to make an extremely long speech, as others want to speak.

Mr. Flynn: The answer to this could be helpful. I have had a long correspondence with Ministers in the Department for Education and Employment in both the previous and the present Government, and I have asked this question many times without getting an answer. Perhaps my right hon. Friend can rectify that. Is there an example of an anti-drugs education programme in this country or in any other country, in this century or in any other century, that has led to a reduction in drug use?

Dr. Cunningham: This is where my hon. Friend and I part company. He seems to be absolutely consumed with the culture of failure. Because things have not worked in the past, he concludes that nothing can work in the future. I do not share that pessimism. Even if policies are not succeeding as well as we would like, the idea that we should give up and do nothing, or leave our children and young people even less well informed or prepared to resist the menace that drugs present to their lives, health and


careers does not recommend itself to me at all. Even when our efforts do not work, that is a reason not for giving up, but for trying even harder to combat the problems.
The drugs strategy is clear in its recommendation that drug education needs to be set in the context of personal, social and health education in schools. My right hon. Friend the Secretary of State for Education and Employment has recently sent out for consultation a framework for personal, social and health education across all four key stages which will do much to strengthen and underpin the delivery of drug education in schools.
Our research programme will help us to develop further our evidence base so that we can target our resources on the most effective programmes of action.
There will be no let-up in our determination to pursue the drug dealers. My right hon. Friend the Home Secretary has introduced a seven-year minimum sentence for third time class A drug traffickers, and we will continue to give the police and other enforcement agencies every support in tackling such offenders.
The framework is in place, the resources have been identified and the targets have been set. It is time for us to start delivering. As everyone accepts and acknowledges, that will be a huge challenge, but we must ensure that the policies in place result in our meeting that challenge. If they do not, we stand prepared to review, alter and develop them in ways that, eventually, will help us to beat the drug problems that threaten so many of our communities.

Mrs. Ann Winterton: I welcome the fact that we are having a wide debate on drugs in Government time. That is completely appropriate, and I believe that it is the first full debate on drugs—we have had short Adjournment debates—in this Parliament.
The Minister talked about the targets that he and his Department have set. It must be admitted—indeed, he did so—that the targets will not be properly assessed until 2002 and there are no baselines yet in place, although I understand that the appropriate research will be undertaken, which is welcome. I am sure that he will accept the political point that within this Parliament the House will have no way of assessing whether the strategy is effective.
When we talk about drugs outside the House people recognise that they are a huge problem and say that something must be done. They are not too sure about what should be done, which is why we need the strategy, but it is important that no claims are made for its success when that cannot genuinely be assessed before 2002. The reality on the streets is that drug taking is on the increase. The use of heroin in particular is rising, and the fact that it is being abused by younger and younger children concerns us all.
The right hon. Gentleman mentioned funding and announced further increases, all of which, although they are to be welcomed, were already known about. I appreciate how difficult it is to prise open the fingers of the Treasury when further expenditure is necessary, but if the Government are serious about reaching and achieving

their targets, they must think about the funding allocated so far. Many organisations in the field have expressed doubts about whether there will be enough resources on the ground to wage the battle against the scourge of drugs in our society, and the lack of consistency in funding and services that characterises the anti-drugs effort in this country now must be tackled as a matter of urgency.
I am pleased that the Government, in building on the approach of their predecessor, are putting flesh on the bones of the policy. I would also like to put down a marker that, in shifting the emphasis to prevention and education, we must not show any lack of commitment to law enforcement. The Government should send a message of unequivocal support both to those who are upholding the law and to the innocent victims of drug-related crime.
A clear message must also be sent to those who favour decriminalisation of certain drugs. Most recently, the British Medical Association's Scottish committee for public health medicine has tabled a motion at its conference to launch a campaign for cannabis to be made legal in certain circumstances.
In legalisation for medicinal purposes, this country leads the world with the trials commissioned by the Home Office, for which I give credit to the Under-Secretary of State for the Home Department, the hon. Member for Knowsley, North and Sefton, East (Mr. Howarth). Those trials seek to test the derivatives of cannabis—the cannabinoids—to ascertain their effectiveness, if any, in alleviating painful conditions in certain illnesses. I do not believe that the Government should act on legalisation in any way until the research trials are completed and have provided what we hope will be clear and unambiguous results.
On the wider issue of decriminalisation, we should remember that all the signatories to the United Nations declaration have reaffirmed resistance to legalisation for recreational use. That includes Holland, which is often cited as an example. The truth about Holland is that its liberal policies have failed terribly. It was claimed that greater tolerance of so-called soft drugs would allow the authorities to concentrate their efforts on the fight against hard drugs, but Holland is now the drugs capital of Europe not only for soft drugs but, according to senior customs officers in the United Kingdom, France and Belgium, for hard drugs, too, including heroin, cocaine and Ecstasy.

Dr. Brian Iddon: Is the hon. Lady aware of the "Altered Minds" programme that Channel 4 broadcast a few months ago, which was also published as a booklet, which I have here? The chief of the Amsterdam police was interviewed, and when he was asked about the legalisation of drugs, he fully supported it.

Mrs. Winterton: Many people support the legalisation of drugs, but what has happened in Amsterdam means that the chief of police there is presiding over a terrible situation; that is nothing to be proud of.

Mr. Flynn: Will the hon. Lady give way?

Mrs. Winterton: I shall make a little progress first, and then I shall be delighted to give way.
Light sentences and liberal regimes in Amsterdam have attracted many international drug traffickers, who illegally supply hard drugs from the legal coffee shops—not


something of which either of the hon. Gentlemen who have intervened, or attempted to intervene, on my speech would approve. I hope that the chief of police in Amsterdam too would be concerned about it.
There has been an explosion in juvenile crime in the areas in which cannabis use is concentrated, and the number of addicts in Holland has tripled since liberalisation. No wonder children in Holland believe that it is okay to take drugs, and move from cannabis, which is legal, to other hard drugs, which are not but which are readily available.
I hope that the Minister will agree that the path of legalisation is dangerous, and that we must not humour those who tell us otherwise. I shall now humour the hon. Member for Newport, West (Mr. Flynn).

Mr. Flynn: I am delighted to be humoured by the hon. Lady. Has she ever visited Amsterdam? If not, will she do so? I would be happy to pay her fare and accompany her around the city; she would probably find it less frightening than her own constituency on a Saturday night. What is the source of the figures that she gave us? Could it be the Dutch embassy, for instance?

Mrs. Winterton: I must turn down the hon. Gentleman's kind invitation to pay my fare to Amsterdam. Others, too, have offered, and all of them believed in the same cause as the hon. Gentleman. I have indeed visited Amsterdam more than once, but not in my official capacity as Opposition spokesman. When I do so again, I shall go at my own expense, and quietly, without someone with a hand up my back pointing me in the direction of the things that they want me to see. I am sorry to say that although I humoured the hon. Gentleman, I must continue to disagree with him.

Mrs. Gillan: rose—

Mrs. Winterton: I shall give way in a moment.
Incidentally, the view of the hon. Member for Newport, West—

Mr. Flynn: What is the source of the hon. Lady's figures?

Mrs. Winterton: They came off the internet, not from the Dutch embassy. I can substantiate the figures, and if the hon. Gentleman wants to see them I will show them to him afterwards.
I must tell the Minister that it worries me that some of the very people working in charitable and other organisations concerned with drugs share the view of the hon. Member for Newport, West and may seek, occasionally if not often, to use their position to push the debate in that direction.

Dr. Jack Cunningham: In case there is any lingering doubt in the hon. Lady's mind or in that of any other hon. Member, may I make it clear that the Government have no intention of decriminalising any illegal drug.

Mrs. Winterton: I am grateful to the right hon. Gentleman for saying that, and I now give way to my hon. Friend the Member for Chesham and Amersham (Mrs. Gillan).

Mrs. Gillan: The hon. Member for Newport, West (Mr. Flynn) has challenged the statistics, but does the

situation in Holland not have an effect on the United Kingdom? Our own Customs and Excise figures show that 80 per cent. of the heroin seized in the United Kingdom had passed through or been temporarily warehoused in Holland. Perhaps my hon. Friend would care to comment on that fact, because it shows that the liberalisation of the regime in Holland directly affects the United Kingdom.

Mrs. Winterton: I am grateful to my hon. Friend for making that point; I intended to make it later in my speech, but she has made it very well and I need add nothing to what she has said.
We must dispel the myth that some drugs are recreational. There is no such thing as a recreational drug, because the word "recreational" means doing something healthy. Using drugs is not an acceptable form of recreation.
It is also true that no drug is soft on the body. The notion that cannabis, in particular, is less harmful than alcohol and cigarettes must be challenged. It never ceases to amaze me that among a multitude of messages emanating from the Department of Health about the dangers of smoking tobacco, almost nothing is said about the dangers of smoking cannabis. Cannabis is more carcinogenic than cigarettes, and its active ingredient, THC, is retained far longer than alcohol or nicotine because it is absorbed by the fatty tissues. The resulting short-term memory loss and diminished capacity for learning may affect heavy cannabis users for longer periods than they imagine, and there is a real risk of dependency.
The effect of cannabis can vary widely, depending on which part of the plant is used, where it is grown, and the metabolism of the person who uses it. In particular, those who use strong varieties or who are inexperienced may become paranoid and anxious. It should be noted that the cannabis that is widely circulated now is considerably stronger—up to 200 times more potent—than that smoked in the 1960s when it acquired a benign reputation. It follows that the health effects of smoking modern cannabis are correspondingly adverse.
We must also spell out the effects of other so-called recreational drugs. We know from widely publicised cases such as that of Leah Betts that Ecstasy can cause death. However, we do not so often hear that it can cause surges in blood pressure which can lead to strokes from bleeding in the brain, memory disturbance and psychiatric disorders, as well as fits, kidney failure, flashbacks and paranoia. We should emphasise that those who take trips on LSD could suffer flashbacks for many years, while children who take speed may find that their growth and development are inhibited. Those drugs have serious long-term effects, as well as the short-term effects of paranoia and anxiety.
We should also be aware that it is common for a cocktail of drugs to be taken. For example, people going clubbing will take speed. They will then need temazepam or cannabis to come down and then more speed to become alert again. That compounds the damage. There is nothing recreational about substances that have such dramatic adverse effects and that may motivate crime, waste futures and pull families and communities apart. The message—from both sides of the House, I am glad to say—is that all illegal drugs are harmful. We must stick to our resolve not to legalise any drugs.
The Government have set targets in their 10-year strategy to reduce the number of people under 25 reporting use of illegal drugs in the past month and the previous year, and to reduce the proportion of young people using the drugs that cause the greatest harm—heroin and cocaine—by 25 per cent. by 2005 and by 50 per cent. by 2008. In this Parliament, we will not be able to assess whether the Government are on track to meet those results.
The objectives are laudable, but I wonder whether the targets are achievable. Does the Minister agree that one of the greatest barriers to achieving them is the culture of acceptance that has grown up among our young people. Mr. Keith Hellawell has spoken often of the normalisation of cannabis in schools, meaning that usage is no longer regarded as abnormal behaviour. The culture of acceptance has spread throughout our society. However—this is the answer to the question put by the hon. Member for Newport, West to the Minister—the American experience demonstrates that a strong anti-drugs campaign with a clear message can have an enormous effect if it is reinforced at all levels of society. The "just say no" campaign was also waged in Britain, but not as successfully because it was not supported.
I shall give the hon. Member for Newport, West some statistics. From 1980 to 1992, a 60 per cent. reduction was achieved in the use of all substances by all age groups. That has been evaluated and proved to be correct. We should take note of the fact that in 1992 drug use began to rise again when parents thought that the problem was solved and the Government became complacent and switched funding to other areas, and some pop stars began to promote the use of drugs. A prevention campaign can be helpful and can put young people off starting on drugs, if—as in America—it is done properly. I hope that the Government will have the energy and stamina to wage effective and unrelenting campaigns to ensure that in this country we do not become complacent after any early successes that we might have.
The economics of the situation are not on our side as far as young people are concerned. For example, an LSD tab, usually a liquid absorbed into paper sheets, can now be bought for around £2.50 and its effects can last for up to eight hours. Perhaps it is not so surprising that young people with limited funds, faced with the availability of drugs, alcohol and cigarettes decide that they will get a cheaper, longer-lasting and more immediate high from drugs. That factor makes our predicament more difficult. We have to ensure that young people are armed with the facts about the dangers to their health of taking such drugs.
We have the worst record in Europe for drug abuse. Does the Minister have any new thoughts on how to tackle drug taking by young people? Has he considered increasing the penalties for pushers who target young people? Can campaigns be targeted differently? Is there any value in gaining the support of those pop stars and other famous people such as sportsmen and women, whom the young admire and who could act as role models?
I commend the Government's efforts to build on drugs education in schools, but the primary emphasis must always be prevention rather than merely harm reduction.

Although the effect of education can often be difficult to evaluate, we can agree that it could play an important role in the prevention of drug use. On best practice in our schools, I wish to draw the House's attention to a joint report recently published by the Association of Chief Police Officers and its drugs sub-committee with the Roehampton institute, London, which suggested that while schools should take the lead in drug education—we all agree with that—police input is valuable, especially in their area of expertise of drugs and the law and at primary school level.
An excellent example is that of the Hampshire police authority. It has 23 full-time primary school liaison officers, covering ages four to 11 and, on the initiative of the 15 areas within the authority, 23 secondary school liaison officers have also been introduced. Officers have a three-week training programme before going into schools, and the programme also covers wider life skills. The authority has built a truly integrated approach with support from personal, social and health education and promotion schemes, as well as parents and governors. Their emphasis on making drugs education fun—for example, through performing arts competitions—was found in evaluations to be effective.
Other schemes have been evaluated and found to be effective. One is the Life Education Centres—I have visited the one in Cheshire—which are partially supported financially by the Rotary club. It is an excellent programme for primary school children, which enhances their self-esteem and social skills so that they can resist peer pressure. Another excellent scheme is run by the drug abuse resistance education—or DARE—organisation, which has already been mentioned this morning. It is perhaps the best evaluated of all the schemes. It is teacher-led, but it sends police officers into primary schools, which is good for the children as well as for the officers who get to know the communities in which they are operating.
I visited the Sir John Cass foundation primary school in the City of London, where the City of London police are backing the DARE scheme. The school has a multi-ethnic mix—there was only one white child in the class I visited. The relationship of those children with the police officers, supported by parents and the school, was worth experiencing.
The Minister knows that funding is the crux of the matter, because effective programmes cost money. The Hampshire police authority spends £900,000 on its youth programme, and DARE in Nottinghamshire spends £740,096.
Does the Minister share my concern that funding is not consistent and that a surprisingly high proportion is provided by the police service? Programmes are funded as a matter of good will, but the cost of evaluation is high and programmes are developed at the discretion of chief constables, who may choose to prioritise other aspects. Will the right hon. Gentleman assure the House that, although the police can play a positive role in schools, they should not be relied on to fund effective and imaginative drugs education programmes for our children?
How will the proposed drugs prevention board help co-ordinate the approach to drugs prevention and education? Will it have a role in relation to funding?


I hope that the Under-Secretary of State, when he winds up the debate, will be able to provide some answers to those questions.
It is imperative that effective treatment is available for those young people whom we are unable to prevent from taking drugs. At present, few drug treatment services are available to young people under 16. They have to wait an average of three months for treatment, but for many the wait is much longer. At the Birmingham conference of the Royal College of Psychiatrists, Professor Harvey Zeitlin, professor of psychiatry at University college, London, pointed to the absence of resources devoted to the treatment or management of juvenile substance abuse. Also, few clinicians have relevant expertise, and that problem must be rectified through appropriate training.
Do the Government support the view that child drug abusers require different services from adults? Is appropriate action being taken to ensure that such services are expanded? Drug misuse at a young age may relate to a range of complications in the life of such children and their families, and hard cases—such as those involving teenage prostitutes living on the streets, or youth offenders—will require the attention of specially trained professionals.
Although young people must be protected from older abusers who may teach them new habits, will the Government reject the suggestion that under-age children might be treated without their parents' consent? Does the Minister share my view that parents are responsible for children under the age of 16, and that that responsibility must not be usurped by doctors or people working in drug treatment agencies or other organisations?
Treatment can be effective only when a young person has decided to give up. According to the proverb, "You can lead a horse to water but you can't make it drink", but once a child has decided to go for detoxification and rehabilitation we must provide appropriate support, as there will often be slips, lapses and relapses during the return to abstinence.
The proliferation of drug abuse can destroy local communities. I welcome the Government's determination to reduce the level of repeat offending by 25 per cent. by 2005 and by 50 per cent. by 2008. It is estimated that, in the past 12 months, half of those arrested who reported using drugs had committed crimes that were connected to their drug habits.
However, I am concerned that the burden of funding for drug treatment increasingly falls on the police. Earlier this year, chief constables were informed that, in future, 1 per cent. of their budgets—or £60 million—could be used for drug treatment purposes. More recently, the Home Office has proposed that everyone arrested who has a drug problem should have the opportunity to be treated. That will place an enormous strain on resources, although the objective is to be welcomed. It is estimated that as many as 30,000 addicts a year could be sent to clinics charging between £500 to £1,000 per person per week. Do the Government still consider that the police should pay for treatment because they will benefit from a fall in crime? The Minister will be aware that police resources are under strain and that the high cost of treatment would be crippling for the service.
Considerable hype surrounded the introduction of drug treatment and testing orders, but the results of the pilot projects in Liverpool, Gloucester and Croydon have been

disappointing. Can the Minister offer any explanation as to why the schemes are failing? He has said in the past that changes will be made if the schemes are found not to be an effective use of resources. When is that point likely to be reached?
When he winds up the debate, will the Under-Secretary comment on the progress of measures to combat drug taking in clubs, which has led to the widespread use of so-called recreational drugs? How many clubs have been shut down or involved in anti-drugs campaigns, and what further progress can be made in that area? The House will know that Operation Bumblebee, aimed at stamping out burglary in the capital, was extremely successful. Can the same tactics be used to fight drug taking in clubs?
In formulating any such operation, it should be acknowledged that drug taking and drug dealing are not confined to the interior of clubs but take place in the surrounding areas. Many clubs search people on admission, so clubbers are more inclined to buy and take drugs before they enter. However, although police blitzes may not stamp out the problem and may even move it elsewhere, they show the authorities' willingness to fight drug taking. I think that that approach has been shown to be effective in the past.
The abuse of drugs can threaten the safety of others in the community. Driving under the influence of drugs or using drugs in the workplace are especially dangerous examples of that. It is estimated that drugs are involved in 16 per cent. of road deaths, and cannabis is identified in two thirds of fatal accidents. However, roadside screening devices are not yet available, although they are being developed. Drugs are abused at all levels in society, and it is important that a strong message is sent out that taking drugs in the workplace is not acceptable.
We must emphasise that the final aim of all treatment should be the eradication of drug use by a person, and that person's complete detoxification. In the short term there are benefits, as the right hon. Gentleman mentioned, from schemes such as needle exchange programmes and maintenance therapy. However, we must be clear that drugs are intrinsically harmful and that we must get people off them.
Private prescribing still poses a problem. Methadone is still leaking onto the black market, despite the guidelines on drug misuse and dependence that were published in April. Will the Government examine, for example, Cumbria's drug action team policy, which I should have thought would be close to the Minister's heart? That excellent policy, under which pharmacists dispense methadone on a daily basis under supervision, has reduced that leakage as well as overdosing.
The fight against drugs needs consistent services and stable funding. Residential treatment places are being lost through a lack of funding. There has been a 25 per cent. drop in residential places in the past six years, and there is a lack of qualified staff to deal with addicts. Extensive waiting times are counter-productive. Earlier this week, I spoke to a number of consultants at treatment centres who told me that patients ready for detoxification need to begin treatment within two weeks. People who are kept waiting for 8 to 12 weeks—the present delay—lose their motivation to proceed with the detoxification. It can take weeks or months for funding to come through for residential accommodation. Addicts may be discharged, or may discharge themselves, without having received appropriate treatment.
Dual diagnosis cases pose particular problems. Patients with mental health problems who also abuse drugs seem to slip through the net. Mental health professionals and drug treatment professionals believe that they do not offer a service appropriate to such patients. Without specific facilities and further staff training, patients will not receive the necessary treatment. Can the Government offer any assurance that facilities and their co-ordination will improve?
An extra £217 million is being put into anti-drugs activities over the next two years, much of it for treatment. Can the Government assure us, however, that they appreciate the need for stable funding for drug treatment? Rehabilitation after detoxification is slow but vital, and continuing support is essential. It is estimated that one month of rehabilitative support is required for each year of drug use. Stable funding would allow staff to be recruited on longer-term contracts—nothing can be done quickly in drug treatment—and would allow drug action teams and agencies to plan their services better. The strategy sets the short-term target of establishing over the next year comprehensive frameworks for treatment in all prisons to improve assessment of, advice for and support of prisoners.
The House will be aware of the findings of the Home Office's report on Wormwood Scrubs and its drugs strategy. To say the least, the report paints an extremely dismal picture, suggesting that drug use was a significant problem and that prisoners did not receive proper support and treatment. The prison's detoxification unit reported in August 1998 that, out of 655 prisoners who had declared a drug problem over 12 months, only 132 were admitted to the unit.
Wormwood Scrubs provides an insight into the difficulty of reducing the availability of drugs in prisons. There was some disagreement over the scale of the problem: specialist drug treatment workers perceived a far greater problem than prison officers. Security was compromised by a range of factors, including a lack of trained staff to operate cameras in the visits area. A passive drugs dog had been introduced only within the previous few months. Cell searching targets were not met, and staff were taken away to other duties. Staff shortages in the mandatory drugs testing team left it often unable to test on suspicion within a reasonable time, and class A drug users may have escaped detection. The report is a litany of disaster, which I hope will not be repeated elsewhere in the Prison Service.
We welcome the Government's aims of reducing access to drugs among young people, and increasing assets seized from drug traffickers. There is no mistaking the scale of the task. Although seizures of illegal drugs multiplied by 10 between 1987 and 1997, availability declined not one jot. We must maintain our commitment to Customs and Excise. Intelligence work is crucial to its success, and front-line resources are needed. I should be grateful if the Minister would comment on the threat to 1,200 jobs over the next three years. The supply of drugs to the United Kingdom seems greater than ever, and it is essential to maintain resources on the front line.
We support the Government's actions in seizing assets from drugs barons and channelling the money into action against drugs. I pay tribute to Strathclyde police and the

Scottish crime squad on their recent success in seizing heroin. I welcome the possible confiscation of illegal drug assets, proposals for which are being considered by a working group. Can the Minister inform us of the group's progress? When will it report?
Reports say that the number of drug factories in the UK and abroad is growing. The National Criminal Intelligence Service has warned that criminal gangs are interested in manufacturing drugs in the UK. NCIS fears an expansion in the manufacture of synthetic, or designer, drugs. Can the Minister assure us that every effort will be made to track down and stamp out drug factories, and every step taken to stem the tide of illegally imported precursor chemicals or drugs? Will he confirm the Government's commitment to seeking effective international co-operation on drugs? We must suppress the flow of drugs to the UK by every means at our disposal. We must suppress drugs—at source if possible, but all along the route into the UK—if we are to win the battle against international traffickers.
We face the enormous task of first controlling and then diminishing the availability of drugs on our streets. The scale of the task is frightening. Support and co-operation are required from us all to ensure that the lives of future generations are not blighted by the scourge of drugs. The lives of law-abiding citizens must not be blighted by drug-related crime. The Opposition pledge our support in the battle. We shall play our part.

Liz Blackman: I am glad that the terms of the debate are widely drawn. There are many interlocking elements in the debate on drugs and their misuse, including prevention, the breaking of dependency, prevention of criminal behaviour and the legal status of categories of drugs. My background is in teaching and working with young people. Abuse is evident in my constituency, particularly among small pockets of young people. Prevention is therefore my key topic.
The British crime survey 1997 said that 25 per cent. of 11 to 14-year-olds had been offered drugs, a shocking statistic. The Department of Health estimates that 40 per cent. of children will try drugs. Abuse exists from the top to the bottom of our society. Prevention must be better than cure.
The White Paper emphasises that drugs education should be an essential part of the curriculum from ages five to 16. What is taught must be coherent. It must be based on good practice, and it must be constantly evaluated. It should be process-based, and long term. I applaud the long-term vision of the 10-year strategy. We must teach in an open way, and teaching must be appropriate to the age of the children. We should recognise why young people become abusers: reasons include peer group pressure, teenage uncertainty, curiosity and domestic unhappiness. It is to be regretted that drug abuse is the norm in some families and communities.
Many programmes exist to tackle drug misuse, some developed by individual schools and others more collaborative. I commend the workings of the drug abuse resistance education project—DARE. I, too, am familiar with it. At its heart is the essential element of good drugs education. There is much to be learned from it.
That project has been running in Nottinghamshire schools for a few years—its remit has now been extended to at least six counties. What is different about it is its


partnership approach. That is apparent in the funding of the project, which it receives from voluntary, community and local authority sources, and from the police involvement, both of resources and personnel. That partnership is also reflected in the delivery of the project, which is carried out by teachers and the police in partnership with children and parents.
DARE originated in the United States and was implemented to protect young children and give them skills to resist drugs and violence. The use of research to promote state-of-the-art knowledge effectively to prevent children accepting and becoming hooked on drugs is continually ploughed back into the programme. There is constant evaluation and the best possible practices are in place. I am a great believer in using whatever works and taking the best possible practice from wherever one finds it.
In Nottinghamshire and the other counties the DARE programme is targeted at junior school rather than younger or older children, although it is right to target drugs education on children from the ages of five to 16. However, DARE is particularly appropriate to the junior school age group. The focus on developing skills to recognise and resist social pressure to experiment with drugs misuse, to enhance self-esteem and to provide and show positive alternatives to substance misuse, to develop decision-making and risk-assessment skills and build interpersonal and communication skills is at the programme's heart. It is process rather than information-based, which is its strength.
The other essential element is police involvement. Sir Richard Mayne said in 1839:
The primary object of an efficient police is the prevention of crime, next that of detection and punishment of offenders if crime is committed. To these ends all efforts of police must be directed.
The DARE project takes that advice seriously. Why is police involvement in the programme so good and effective? Children can relate the anti-drugs messages to the real-life experiences related by police officers. They see the officer as a credible source of information and a good role model. It is a good opportunity to meet the police in an educational context. The children recognise them as real people—fellow citizens—endorsing law-abiding behaviour. Time working on DARE enables officers to develop the skills identified in the Macpherson report, which resulted from the tragic death of Stephen Lawrence.

Mrs. Gillan: I am listening carefully to what the hon. Lady is saying about the DARE project and she knows that I, too, support that approach. She will probably know that it is a franchise scheme that came from the United States. It has been taken up in more than 40 countries. A great help to the scheme has been the close involvement of personalities and the fact that television stations show cartoons on the subject to enthuse children about it, for example. Does she agree that it is to be hoped that more personalities and more of the media here will get behind a project such as DARE, so that it can yield the success rate that it had originally in America where it started 17 years ago?

Liz Blackman: With any good initiative that has such widespread results I would endorse media backing and exposure. I entirely agree with the hon. Lady.
At the heart of the education process is the objective of developing high self-esteem in children. From that flows the child's ability to say no. Schools and colleges must build self-esteem not only through a dedicated drugs element in their citizenship and personal and social education programmes, but through everything that they do. That is what the whole input should be about. That means high-quality teaching to ensure good core skills, literacy and numeracy, access to a relevant and appropriate curriculum and good links with the home—literacy links and involvement in children's learning.
In certain areas with high social need additional resources are required. Resources such as sure start and education and health action zones will help to build on the quality of children's experience. High self-esteem is, of course, built in families as well as in the schools and communities in which young people live. Decent housing and opportunities for employment are also important. A lack of those fosters a breeding ground for drug pushing and misuse, crime, despair and low self-esteem. Where those opportunities are absent, sub-cultures develop that move beyond society's norms because they have no stake in society. I applaud the Government's initiatives such as the new deal, working families tax credit and the estates action programme. Prevention is long term and will require a multi-faceted package and approach.
Inclusion is about skills, earning ability, feeling able to make a contribution and taking responsibility. I commend the Government for taking such a holistic view and driving forward a long-term prevention agenda, but I do not deny the need to tackle dependency and crime. When some very small children in my constituency go to school they say goodbye to a drug-dependent parent or sibling. I want us to concentrate on prevention as a more effective way to change the drugs culture.

Mrs. Jacqui Lait: I begin by apologising to you, Mr. Deputy Speaker, and to the House, as I have to leave to attend a constituency function and I will not be here to hear the replies. However, I look forward to reading Hansard. I will be most appreciative if the Minister responds to any of my questions.
Having listened carefully to the debate, I have been struck by the fact that other than a brief reference by the Minister for the Cabinet Office little has been said about the origins and source of drugs. There is widespread acceptance that we must deal with the problem and I do not for a moment disagree, but we must also tackle directly the source of supply.
Perhaps I am being innocent and naive, but I want the farmers who grow coca leaves and poppies to have a replacement crop that is equally valuable to them. I know that that is easier to say than to do, particularly when one considers the involvement of the crime cartels in central America.
Thinking tangentially, as modern pharmaceuticals are developing and more links are being made to drugs that stem from the natural world—from trees and plants—those could be a source of new crops that those farmers might find more valuable. Hence, the pharmaceutical industry could get involved and there would be a beneficial effect in producing some of the new and rare drugs that are needed to treat the ever more complex


diseases to which the peoples of the world are subject. I hope that the Government are not focusing on that matter only through the United Nations, although it does a good job. Given our long-standing programme of aid to the world, we should be more directly involved in such programmes.
Once the drugs have been manufactured, they are, unfortunately, imported into this country—a statement of the obvious. I was alarmed to hear from my hon. Friend the Member for Congleton (Mrs. Winterton) of the possibility of job losses in Customs and Excise. As the House will know, one of the subjects that I have raised on many occasions is that of the smuggling of tobacco and alcohol. The Government have allocated extra front-line and intelligence resources to customs. Given the Government's policies to increase taxation on tobacco and alcohol, the problem of smuggling will become greater. If that is allied with increasing imports of illegal substances, I am seriously alarmed at the prospect that 1,200 jobs in customs will be cut. Alternatively, it may mean that the Treasury may have a change of heart and will reduce the duty on tobacco and alcohol, hence removing the profit from smuggling. That will reduce the work of customs and, perhaps, justify the loss of 1,200 jobs. However, that is a separate subject.

Mrs. Gillan: Is my hon. Friend alarmed—as I am—that the Minister did not instantly leap to his feet to rebut those rumours? By his acquiescence, he contributes to the rumour of forthcoming cuts among Customs and Excise personnel.

Mrs. Lait: I agree entirely.

Dr. Jack Cunningham: Will the hon. Lady give way?

Mrs. Lait: May I answer my hon. Friend?

Dr. Cunningham: I should like to answer the hon. Lady too.

Mrs. Lait: I was about to suggest that, as the Under-Secretary of State for the Home Department was looking so absorbed and intrigued, it meant that we would receive a definitive answer on the subject in his summing up. However, if the Minister for the Cabinet Office wants to make a point, I am happy to give way.

Dr. Cunningham: I merely remark on a significant change of tune on the part of the hon. Lady and her hon. Friend the Member for Chesham and Amersham (Mrs. Gillan). They supported a Government who actually did cut the number of front-line Customs and Excise workers—it was no rumour. They had prepared to cut several hundred more jobs, but we prevented that. Perhaps we should deal with facts rather than rumours.

Mrs. Lait: The rumour comes from the customs workers' unions. Perhaps the right hon. Gentleman can discuss that with them. I point out that my right hon. and learned Friend the Member for Rushcliffe (Mr. Clarke), the former Chancellor of the Exchequer, was doing something positive to reduce the incentives to smuggle

tobacco and alcohol. The current Chancellor, however, is exacerbating that smuggling by increasing taxes on those commodities.

Mrs. Gillan: I thank my hon. Friend for her generosity in giving way again. Does she agree that it is rather poor that the Minister for the Cabinet Office should rush to his feet, not to deny the rumoured cuts, but to attack the previous Government? Was that not a poor intervention? It adds fuel to the point made in my first intervention on my hon. Friend.

Mrs. Lait: Given the exchange that has taken place, I am sure that the Minister will either confirm or deny the rumour in his reply. If he does not, we shall draw our own conclusions. However, one hopes that the customs unions will be reassured by his answer.
We have talked a great deal about the systems that are being set up—the co-operation between the police and health and social services; the new teams; the bureaucracy and the processes. However, it is striking that few contributions so far have focused on how we try to help those who are addicted to drugs—apart from that of the hon. Member for Erewash (Liz Blackman), who briefly mentioned that matter. If we cannot help those people, then those systems are no more than an enormous and expensive superstructure.
I am sure that, in all our constituency surgeries, we have seen people with their sleeves rolled up showing the blisters and scars from injections. That is a most off-putting sight, to say the least. When people have been injecting for a long time, there is not an inch of their arms that has not been destroyed in some way. We have to deal with that reality; we should not have to satisfy the bureaucrats who have set up a nice process that helps them, but may not help the addicts. What concerns me about all the Government's proposals is that they would try to make addicts fit into the system. That is why I intervened on the Minister for the Cabinet Office; I am concerned that there is too great an element of coercion in the system.

Liz Blackman: Does the hon. Lady accept that we are talking about two sides of the same coin? We need to teach young people who are not yet on drugs to say no. That cannot be done by lecturing at them; we need a process whereby they feel able to say no. At the same time, we need to deal with people who are dependent on drugs. The one does not negate the other; both are important.

Mrs. Lait: That is absolutely right. Indeed, I could talk at great length as to the need for the effective education of young children. In my own family, young boys aged 5 can talk knowledgeably about drugs, but they have a built-in self-esteem because they have learned about those matters from an early age. They also have fulfilled lives; they are busy and happy and that is the key to giving them the self-confidence to resist drugs. However, from our surgeries, we all know that unfortunately not everyone is as lucky as that.
As we all know, the problem is that addicts often turn to crime. I was myself the victim of a drug addict when, in Portugal, my handbag was stolen. The Portuguese police handled the matter brilliantly; within two hours, I had


everything back, including my passport and my cards—which I had, unfortunately, cancelled. The thief was a drug addict, and the police knew where to go to find my belongings, because they knew who the drug addicts were. I am sure that we should find that it was the same in our constituencies. The police are well trained; they know who the drug addicts are and how to find them.
In many cases, the police try to get the addicts out of the system. However, unless the addicts are deeply convinced that they want to give up drugs, we shall never succeed. That is where the problem of coercion comes in. While drug addicts are feeling remorseful—should they ever feel remorse—they may agree temporarily to try detoxification. They may agree that their life style is chaotic and that they do not like what they are doing—mugging people and shoplifting. They will agree to anything to get themselves out of that predicament, but then the element of coercion comes in. They are told that they must attend a residential course—if they can get on to one; they must see a social worker; they must do this and they must do that. From my experience of addicts—whatever they are addicted to—I know that, unless they own the treatment, and it is not dictated to them, at some point they will rebel. They may go through the treatment and be detoxified, but they will go straight back on to the streets, if they do not own the belief that they want to stop being an addict. That is my concern about some of the systems that the Government are setting up.

The Parliamentary Under-Secretary of State for the Home Department (Mr. George Howarth): I had not intended to intervene, but since the hon. Lady has been courteous enough to say that she will not be here for the end of the debate, I think it would be as well to respond to her point now.
I ask the hon. Lady to reflect on the fact that the motivation behind much of our approach, which she thinks is slightly coercive, is that the criminal justice system—from arrest to sentencing to serving the sentence—offers us a good opportunity to deal with people who are afflicted both by drug addiction and by the criminal activity that often accompanies it. I hope that she agrees that that opportunity should not be wasted.

Mrs. Lait: I would not disagree for a moment that the opportunity should not be wasted; I am not saying that those programmes should not be in place. However, unless addicts themselves genuinely believe that what they are doing will help them, they will simply be going through the motions and they will not succeed, with the result that there will be relapse after relapse.
I dearly want the Minister to tell me that the Government will not be too prescriptive. A constituent of mine attends a clinic in the east end of London. The clinic is finding life extremely difficult because of the Home Office presumption that its method of treatment feeds drug addicts' habits, rather than stabilises them. The clinic's approach is different—it does not fit into the neat and tidy pattern that characterises so much of the Government's action.
The clinic has 865 long-term addicts, many of whom have been injecting for 25 to 30 years; they have been in and out of prison, detoxified, and have repeatedly gone back to the streets. The clinic's method of treatment does not fit easily into Home Office prescriptions, but it gets

the addicts stabilised by providing the social and emotional support that so many of them need. A number of those treated by the clinic are now almost drug free and they have re-established good relations with their families, so they are now less of a problem to the rest of society. I do not want clinics that offer adventurous treatments to be closed down because they do not fit into the neat pattern that the Home Office has decreed is the best way to deal with the problem.
Finally, there is a pressing need for general practitioners to have greater skills in the treatment of drug addicts, and for GPs to be able to fit drug addicts into their practice without other patients feeling that they no longer want to attend the practice. Because of drug addicts' chaotic behaviour, many GPs feel that they cannot treat them in their surgery. More training of GPs in how to treat drug addicts and the options available for that treatment is needed.
My principal concerns are that drug use should not emerge in the first place and that those who are addicted to drugs have the widest possible range of opportunities to break their addiction. I hope that the new structure will be more flexible and that it will not use too great a degree of coercion.

Dr. Brian Iddon: I congratulate the Government on allowing this morning's debate on an issue that affects the lives of millions of our citizens.
I first became interested in brain chemistry in the early 1960s, when I carried out research for my PhD on serotonin agonists and antagonists. Serotonin is a chemical that helps to maintain brain balance: an excess in the brain leads to excited states, whereas a shortage produces depression. Many other chemicals can either alter the levels of serotonin in the brain, or emulate or antagonise its behaviour. From that time until the general election in May 1997, I was responsible for synthesising thousands of new compounds with potential biological activity. Therefore, my background gives me an interest in the subject of today's debate.
In early summer 1997, Dillon Hull, aged five, was tragically shot dead in my constituency in a drug-related attack on his father. That event rocketed me into the politics of drugs. At that time, I called for a royal commission to discuss that complex area of social policy; I still believe that such a commission is needed. Later this year, the Police Foundation will deliver the results of its two-year inquiry, and I hope that the Government will seriously consider the conclusions, whatever they are. Other important reports have been published since the 1997 general election—for example, the report of the House of Lords Science and Technology Committee on cannabis for medical usage.
I believe that the Government are seriously committed to dealing with the problem of misuse of drugs. In addition to the £1.4 billion already committed to that area of expenditure, £217 million has been allocated from the comprehensive spending review, to which the proceeds of seizure of dealers' assets can be added. The Government have appointed two people to have direct responsibility for this issue and they report directly to the Cabinet Office. The document "Tackling Drugs to Build a Better Britain" was published in April 1998 and, more recently, the first annual report and national plan was published; it sets some very ambitious targets for the future.
In 1998, all drug action teams—DATs—completed a template. Collectively, those have provided the UK anti-drugs co-ordinator with a review of all current work, and have identified gaps in service and priorities for the future in all regions of the country. I am pleased to say that the different agencies in my town, Bolton, are working together extremely well to tackle a complex problem in partnership. In a recent letter dated March 1999, the drugs co-ordinator referred to those templates as "draft plans", which has caused some confusion among DATs across the country. Now, I understand, the drugs co-ordinator expects strategy plans to be constructed on the back of the templates. However, most responsible DATs, such as the one in Bolton, have realised the urgency of their work and have already put plans into action.
The setting of targets by the Government has also caused some concern, because baselines are only now beginning to be established. Many agencies—more every day—are still collecting data to construct more accurate baselines, against which future progress can be measured meaningfully. I am pleased that the Government have committed £6 million to research to improve the database.

Dr. Jack Cunningham: I should first acknowledge that my hon. Friend and I studied together for our PhDs many years ago. His commitment to science continued for many years after I had been hijacked by the Labour party and drawn to this place.
My hon. Friend mentions templates and DATs, and I visited the Lancashire DAT recently. Even more recently, we held a conference of the chairmen of all the DATs in the country and we shall soon follow that up with a similar meeting with all the full-time co-ordinators. We recognise that they need clear guidance and continuing dialogue with Keith Hellawell and Mike Trace, both of whom are doing an excellent job. We have many lessons to learn from the people working on the ground in the DATs and we are determined to learn them.

Dr. Iddon: I am grateful for my right hon. Friend's comment.
DATs were originally set up with an overall co-ordinating role for the agencies working within their boundaries, but they now feel that they are expected to take part in the delivery of policy.
Schools are autonomous bodies and responsible for education policy delivery, with guidance from central and local Government. Similarly, health authorities are responsible for the delivery of health policy. I suggest that DATs must receive clear guidance if their role has changed recently—and they believe that it has. A perusal of the literature, including the excellent Home Office reports, demonstrates that we cannot afford to waste any more time because things are getting worse, day by day. There has been a dramatic rise in heroin usage and the age of users is decreasing. In countries with more radical policies, such as the Netherlands, the opposite is the case.

Mr. Howard Flight: I may be anticipating the hon. Gentleman's next comments. However, in view of his medical background and direct experience in this area, I am extremely

interested in his views on cannabis. Does he believe that its usage leads to the use of more serious drugs and should remain illegal, or should we concentrate on attacking major drugs?

Dr. Iddon: I should point out that I am trained not in medicine, but in chemistry. I will refer to cannabis later in my speech.
The European Association for the Treatment of Addiction (United Kingdom) is a charity that seeks to improve access and quality in the treatment of people who depend upon alcohol and other drugs. Its members are 35 United Kingdom-based treatment centres, which are responsible for 4,000 treatment episodes a year. They reported recently that the level of state-funded treatment among providers has dropped in the past three years. Some centres, including NHS-funded centres, have closed and others, such as Drugs Northwest, feel at risk. That centre has only 24 beds and must serve the whole north-west region. Those facts are supported by the Standing Conference on Drug Abuse—SCODA.
I believe that the purchaser-provider split in the national health service has caused those problems for state-funded drug treatment centres because they are often regarded as the last places to which money should be directed. I hope that the extra Government money will quickly reverse that depressing trend. The new drug testing and treatment of offender orders being piloted depend on that. I agree with other hon. Members that there is a dire need for treatment of those in the under-18 age group.
My interest in this area of social policy has made me realise how much we depend on the voluntary sector, which is highly motivated and carries out some excellent work. There are some gaps, such as a need for more support groups for users. However, I have concluded that there are enormous numbers of such groups—small and large—and that better co-ordination between them would be useful. Why not have a national organisation like Age Concern that we could call Drug Concern? I recognise that some organisations, such as SCODA, are attempting to play a co-ordinating role, but they are not all-inclusive.

Mr. Michael Clapham: Does my hon. Friend believe that the new community safety agencies established under the Crime and Disorder Act 1998 could play an over-arching co-ordinating role between all bodies operating in a particular borough and focus their attempts to deal with the drug problem?

Dr. Iddon: I would certainly welcome that possibility in the future.
I am chairman of the all-party drugs misuse group, and I take this opportunity to invite all hon. Members present for this debate to attend our meetings if they have not already done so. We are currently investigating the links between drug misuse and mental health. However, I must emphasise that my comments this morning are my own and do not represent the views of any member or members of that group.
People who misuse drugs can, and do, seriously damage their brains. There is clear evidence that Ecstasy damages the brain—we have still to establish whether that damage is reversible. This message appears to be getting


through to those who use Ecstasy, thanks to the assistance of the more responsible dance magazines, such as Mixmag. Other factors might be responsible for a drop in its usage, such as the fact that cheaper alternatives are now available—which, unfortunately, includes heroin. It is now being sold as Brown—a drug that is "safe to smoke". It is not, of course, and we must concentrate on getting the dangers of that evil drug across to our young people in particular.
As the dance scene changes, so do the drugs. So culture plays an important role in the misuse of drugs. We need "clean" role models that our young people can look up to—whether in the entertainment world or in the sports field. The misuse of drugs can, and does, often lead to mental illness. Cocaine and amphetamines will produce psychotic episodes in particularly vulnerable individuals. On the other hand, people who are mentally ill often misuse drugs as an escape mechanism.
Many people are both mentally ill and on drugs. Dual diagnosis—which has been referred to already—is not yet common in this country. We continue to treat people on psychiatric wards without also treating the possible cause of their problems, which is a complete waste of valuable national health service resources. In the United States of America, 50 per cent. of those with a mental illness are believed also to misuse drugs. This is a difficult area in which to collect data, because the illegality leads to a fear of admission. In the United Kingdom, the figures are estimated to lie between 30 per cent. and 50 per cent.
Drug misusers often have multiple problems: unemployment, homelessness, involvement with the enforcement agencies, relationship breakdowns, mental illness and poor health in general. Consequently, their lives can be chaotic and they are the army of the socially excluded. They are often unknown—and not even counted by the census. We really do not know how many people are in this army, but at least the Government are attempting to address their problems through their policies and trying to prevent any more people joining up.
Even if such people are on benefit, they will present problems—when they enter the new deal gateways, for example. Unless their drug misusage is addressed, it is doubtful whether they will be able to concentrate on employment opportunities. I hasten to add that some addicts can, and do, hold down responsible jobs by being clinically maintained. They do not have to rely on the street market for dangerous supplies of their drug of choice, which is often heroin.
The witnesses that the all-party drugs misuse group have heard from have given us some interesting evidence that we will include in a report to be published in the autumn. One woman told us that she felt safer in prison than on a psychiatric ward because she knew how long she would be in prison, whereas the psychiatric ward wanted her back in the community as quickly as possible. She added that it was easier to get back into prison than on to the psychiatric ward. Another witness made the perfectly valid point that society, including schools, does not teach children how to deal with their emotions as they grow up and, in adulthood, these can become unmanageable in some cases.
Mike Ward from Surrey social services has re-examined a number of high-profile homicide cases in which the coroner concluded that the perpetrators were mentally ill and that this was the cause of the murders.

By talking to the friends and relatives of those convicted of the crimes, it became obvious to Mike Ward—who has written a book on the subject—that, in the majority of those high-profile homicide cases, the misuse of drugs, rather than mental illness, had caused the murders. Such cases have stigmatised mental illness, and we need to put that right.
Those working in the drug treatment field desperately need to know more about mental illness and those working with the mentally ill need to know a lot more about drug misuse. Funding mechanisms for those two areas of activity need to be brought closer together, and I hope that the Government will address those problems.
The Mental Health Act 1983 is out of date—I understand that the Government are currently reviewing it. I believe that any new mental health Act should include a reference to the misuse of alcohol and drugs. Rehabilitation for drug misusers following in-patient treatment is another problem that must be addressed. Returning a detoxified patient to his or her community and allowing renewed contact with his or her peer group results in the "revolving door" syndrome. In any case, some rehabilitation units will not accept clients who have been dually diagnosed. Although they are recovering from a mental illness, they are unwelcome in those units because they are known to be clinically maintained on illegal drugs.
Although I recognise that there is a place for methadone in drug treatment programmes, the House should not forget that methadone has resulted in more deaths than heroin and we need to review the way in which it is prescribed. I know that the Home Office and the Department of Health have the matter in hand. People who are maintained on methadone while working cannot be expected to visit a pharmacy daily. However, we cannot continue to allow methadone to leak on to the streets in ever-increasing amounts and become a street drug in its own right.
There are safer alternatives to methadone, and I have been urging the Government to investigate their use. Buprenorphine, for example, is now licensed for use in the United Kingdom, but it is not yet in common use because of a technical problem that has been drawn to the attention of the Secretary of State for Health. Buprenorphine is the drug of choice in countries such as France, where methadone is hardly used. It would also be helpful if the Secretary of State would allow laevo-methadone and laevo-alpha-acetylmethadol to be used by practitioners, at least on an experimental basis.
Drug trafficking is the best pyramid selling racket in the world. It is exploitation, mainly of the poor by the rich. Merely removing personnel from any level of those globalised financial pyramids, whether they are people at the base or Mr. Big at the top, does not and will not stop that trade. Those pyramids have an almost magical ability to reform. Profit is their driving force. Raw materials are plentiful and cheap, profits are high and the operators pay no taxes—at least not to Governments. That is the alternative economy, or the black market.
Ironically, tougher enforcement—the Tory approach—is good for business because it drives up street values and increases profits. Prohibition is not, and never has been the right tool to deal with such rackets. The black market in drugs is the third largest industry in Britain. It is larger in volume than steel or oil, and it is a rapidly growing,


supply-led market. Over the three years from 31 March 1993, the number of heroin users aged under 19 increased by 35 per cent. Between 1995 and 1996, smack seizures increased by 52 per cent., according to a recent Home Office report.
That report is one of the best that has emerged from the Government, but it makes depressing reading. It rightly addresses one substance. Too often, in a debate such as this, we try to deal with all substances of abuse together, which is probably a mistake.
Drug trafficking not only damages our health, but seriously damages the country's economy. Most of the profit, after laundering, flows out to offshore tax havens. For many years it has been my considered opinion that the only way to deal with that problem is to collapse the financial pyramids by removing the profit incentive or by reducing profits to the levels of other industries. Whether we like it or not, to do that we would have to consider decriminalisation or even, if United Nations conventions would allow it, legalisation of illicit substances.
I am pleased to say that that right-wing newspaper, the Daily Mail, in its editorial on 26 May 1997, made the point, with which I agree, that if, in future, current Government policies do not work—like others I am prepared to give those policies a chance—we will have to return to the problem and consider decriminalisation or even legalisation. Surveys demonstrate, however, that at the moment the general public would not agree to such a radical approach, but things are changing, as the Daily Mail editorial reveals.
Before 1971, the general public accepted the idea of legalising substances such as heroin. Following the abandonment of the British system of dealing with abusers and addicts and the adoption of the American system, an ever-increasing proportion of our society has misused substances. I include alcohol in my definition of those substances.
Until this year, it was costing £1.4 billion to deal with the fall-out from drug abuse, and a high proportion of that money is being targeted at misusers, or users, of cannabis. I call for the decriminalisation of cannabis to release those valuable resources so that we can tackle the real problems, which are the evil use and sale of heroin, as well as other drugs such as cocaine and amphetamines.
I am pleased that the Government have seen fit to allow the first clinical trials in this country to ascertain whether cannabis has medical properties. Like many others, I believe that it does, and I look forward to the results of those clinical trials, which I understand might be published next year.
Significantly, the average age of heroin addicts in the Netherlands is 38. The Home Office report to which I have referred reveals that in Britain, however, even 10 to 14-year-olds are now taking heroin, with the 14 to 25 age group being at the greatest risk. We must be doing something wrong.

Mrs. Lait: I am now slightly confused about whether the hon. Gentleman wants to decriminalise only cannabis or all illegal substances.

Dr. Iddon: I am in favour of a step-by-step approach. I should certainly allow the use of cannabis for medical

purposes tomorrow, and I am already on the record as having said that. However, that step would not entirely work because there is a grey area about who are the people who need cannabis for medical purposes. We would get into a terrible dispute about that. In any case, as I already said, I believe that we are wasting valuable resources on catching cannabis users and locking them up.
I shall cite an example from a letter that I received recently. Two teachers grew six cannabis plants at home for their own use; they were not selling the drug. We—society—trained those teachers, and I understand that they were excellent teachers. Somebody reported them to the police; they were caught, punished, lost their jobs and are now on benefits. That does not make sense. We have wasted the lives of two excellent teachers, whom we now have to maintain on benefits. I challenge anyone to argue that that is right.
The secretive nature of substance misuse means that we do not know the scale of the problem. However, it is likely that as many as 5 million people in this country are using cannabis for medical or recreational purposes—that is 8 per cent. of the population. If that is the case, and so many people are prepared to break the law, I ask Home Office Ministers whether that law is right.

Mrs. Lait: I now understand the hon. Gentleman's point about cannabis, but does he want to decriminalise heroin, cocaine and other, chemical drugs?

Dr. Iddon: I have already said that I am in favour of a step-by-step approach. I would first find out the results of the decriminalisation of cannabis. If—I stress the world "if'—that worked, I would be in favour of returning to the pre-1971 situation, in which heroin addicts did not have to go on to the street and rob people to pay for street heroin. That drug is often extremely dirty, so it is not the heroin that kills users who inject it but all the impurities that are dumped in it so that the profiteers can make more profit. If I clinically recognised a heroin addict, I would want him to go to a clinic for pure heroin, and to be persuaded, with the help of psychiatrists and other support mechanisms, to come off the drug.
The way in which this country deals with heroin addicts at the moment is crazy. They are sleeping on the streets at night all the way from here to Victoria station because no agency can deal with them. That is madness. So, I am in favour of a step-wise approach and I might even consider the legalisation of all drugs, because I do not believe that prohibition works.

Mrs. Gillan: rose—

Dr. Iddon: I must finish my speech, because I have taken up far more time than I intended to do.
Drug misuse is a health issue with criminal consequences and should not be regarded foremost as a criminal issue with health consequences. I am very pleased that the Government have recognised that and are moving, as many of us have asked, in the direction of prevention and treatment rather than further and further enforcement, as the Tories appear to want. I am sceptical, but I am prepared to give the Government my support and to see what happens in the next few years. We must continue to debate this subject because it is of grave consequence to many of our citizens.

Dr. Vincent Cable: I echo the tributes that have been paid to those involved in the drugs strategy: Mr. Hellawell and his team and the drug action teams at the grassroots. Politically, I and my colleague endorse the unequivocal opposition of the Minister for the Cabinet Office, the Home Secretary and his team and the Leader of the Opposition to the decriminalisation of drugs. There is cross-party consensus on that, and I endorse it.
I agree with the hon. Member for Bolton, South-East (Dr. Iddon) that this debate must be conducted in a framework in which we are open to new arguments and new evidence. If there is new medical and criminological evidence, we should be receptive to it. I agree with him that one useful step would be a royal commission, because that would enable all new information to be considered openly. Since he has put very trenchantly—and, given public opinion, quite courageously—the case for decriminalisation, I should like to make some points back to him on why I think there is a strong consensus among all three parties against such a view.
First, there are the health arguments. I am not a medical doctor and I am not a chemist. The hon. Member for Congleton (Mrs. Winterton) summarised the evidence very well. Yesterday evening, I read through the summary of the literature that Professor Heather Ashton has assembled on cannabis, which is almost certainly the least offensive drug on health grounds. She makes the case that there is considerable evidence that cannabis, even as a relatively inoffensive drug, creates severe problems—it is carcinogenic, has a psychological impact and has serious respiratory effects.
Moreover, the evidence is hardening over time. That is partly because, as the hon. Lady said, the drugs that are now being used are more potent and medical research is finding more evidence. That is not surprising; we went through a similar process of discovery with tobacco, which 50 years ago was not seen as a particularly dangerous drug but is now much better understood.

Mr. Flynn: Does the hon. Gentleman agree that the evidence of the danger of cannabis is as a result of the fact that it is smoked? If it became a legal drug, particularly for people who are sick, it could be used in other ways such as in inhalers, as tabs or tinctures. Does he not see that as a great advantage which would greatly reduce the risk that people currently take when using cannabis?

Dr. Cable: The hon. Gentleman makes an important distinction, to which I shall return: the use of cannabis in a medical, as opposed to a recreational, context. There are separate arguments, to which I shall come. We may have to consider that issue more flexibly, although the health evidence seems to be powerful.
By far the most important argument in this debate is that it is very difficult to see how we can possibly decriminalise drugs without creating a significant increase in the number of users. The basic point is one of economic logic. If one stops the interdiction of supplies, supply in the market increases and the price goes down. Other things being equal, people will then tend to consume more. That simple proposition is supported by evidence. In places like Alaska, where there has been decriminalisation, that is precisely what has happened.
It is easy to be panicked by the argument that, since drug abuse is rampant, it is out of control. Everything is relative. We know from evidence that although many young people might use—particularly—cannabis once or twice, they are discouraged by legal sanctions from continuing to do so regularly. The penetration of the market—if that is the right phrase—is much less than in the case of drink and cigarettes, and it should be kept that way.
The third prohibitionist argument is that it has never been clearly explained how we could set up an alternative structure to realise the very tempting vision of the Treasury receiving all the revenue rather than the drug barons—by taxing drugs. How would that work? If the tax were fixed below the street price, there would be an incentive to consume more. It is more likely that the tax would be fixed at a higher level. Then there would be all the incentives for smuggling and adulteration that we see at the moment.
Those of us who are involved in the passage of the Finance Bill know what is happening with the enormous bulk smuggling of cigarettes. The problem of policing and criminality reappears in a different form. We all know of the great difficulties in policing under-age smoking and drinking—12-year-olds buy cigarettes. One is simply translating the criminal problem into a different sphere; it is not solved.
The hon. Member for Bolton, South-East mentioned that we are dealing with an international issue and an enormous international business, the turnover of which is roughly estimated to be equivalent to that of the oil industry. That is why we cannot have a strategy that is based on decriminalisation in one country. Once we start fragmenting national responses in individual countries, with maverick countries decriminalising their industry, we undermine any concerted Government action against the international trade.

Dr. Jack Cunningham: I intended to say in my speech that I apologise to the House for not being able to stay for the duration of the debate, as I would have wished. I must say how much I agree with what the hon. Gentleman is saying. There is no evidence that the countries bordering the Netherlands have been in any way convinced that they should follow suit on policy decisions. Nor is there any evidence that if Britain were to decriminalise one or more of the substances, it would have the slightest effect—for the reasons that he has given. No one believes that criminals involved in trafficking and trading will register as legal providers and start paying taxes to the Chancellor of the Exchequer.

Dr. Cable: I thank the Minister for his intervention; I entirely agree with him. Given the controversy, I am surprised that so many countries have held the line on policy. There has been some marginal legalisation in, for example, criminal penalties in Italy, but it has been relatively little, and we should not be taking the lead in that area.
I return to the point with which I started. Governments must be open to new arguments and persuasion, and that is why I support the idea of a royal commission. If there were overwhelming evidence from the police and the medical profession that we should change our stance, we should not be bound by dogma and we should listen.


Indeed, the hon. Member for Newport, West (Mr. Flynn) introduced the idea that there might be one area in which we need to look at the evidence much more flexibly: medical usage. I am not persuaded of it, although it is possible that policy might have to evolve.
I have a similar constituency case to that mentioned by the hon. Member for Bolton, South-East. My constituent was busted by information from a neighbour a few weeks ago. His flat was turned upside down, and he is now in court. As far as I understand the case from what he has told me, he was a law-abiding individual who did not want to become involved with drug pushers, but his wife has a serious medical condition and he thought it was necessary to her health to gain access to cannabis, so he grew it at home. That might be a fairy story, although the evidence that he presented is plausible. We all operate on the principle that good cases can make bad law. We need much more persuasion before changing things.
That it why it is important that the Government see through the medical trials, which I think have been authorised, and that we should see what happens. Even then, it does not automatically follow that if the evidence of the medical benefits of cannabis is compelling, it should be legalised. There are all kinds of other problems. We know from the use of opium by doctors that they expose themselves to attacks. It is difficult to separate the medical and non-medical legalisation practically. Several steps may have to be taken before that is to happen. Certainly, if the policy is to go in any direction, that is the direction that it would have to be.
Let me now take up some of the issues that have been mentioned in relation to the Government's strategy. I strongly support the principle that the Minister set out in his introductory remarks. He said that his strategy is geared to treatment, lays a strong emphasis on education at all levels, and involves a willingness to use Government money to save Government money. The idea of spending £1 to save £3 is compelling. As in many other areas of Government policy, such as education and health, the problem here is that, although many commitments are being made to public expenditure, people at the sharp end often do not see it. That is partly because many of the services on the front line, such as the Metropolitan police, are under severe pressure, and partly because the policy depends on grants from local authorities to voluntary organisations—the local authorities are under pressure and the grants do not get through. Thus although I welcome the commitment in general terms, we know from constituency experience that the money often does not appear where it is needed.
I have several other specific questions. The first relates to how we monitor the success of the strategy. As the Minister explained, there are genuine problems with time scales and statistics. We understand that. My only suggestion is that the Government publish price data. Police intelligence would make available information on the price of the main drugs on the street, which is a good indicator of the success of policy. Whether or not putting resources into catching cannabis peddlers is a good priority, it seems to have worked because cannabis prices have been rising. However, the price of heroin has halved in the past 10 years, which suggests that the policy is not working in respect of that drug. Price is probably a better indicator than much-sampled survey data on drug addicts.
Secondly, I should like to know a little more about drug treatment and testing orders. It has been suggested that the policy is not working, and one reason may be that very few orders appear to have been made—only 67 up to the end of May. Why have there been so few and why has that perfectly sensible idea not operated on a much more significant scale?
Thirdly, we all know that drug abuse is common in prisons and that many people are in prison because of drug problems. The Minister knows, because I have had an Adjournment debate with him on this subject, that I am concerned about the extent of drug abuse among young offenders. The Feltham institute in London, an old borstal, has an enormous prevalence of drug abuse among 15 and 16-year-olds, most of whom are there on remand. My worry about that centre—it must be true of many other prisons—is that despite good intentions, the drug rehabilitation programmes simply are not happening. Why is that, and when will we have a clear policy on it?
Fourthly, there is declaratory support for drug treatment centres on all sides, but I am told by the voluntary organisations working in this field that it is enormously difficult to get on to treatment programmes. The average waiting time for in-patient detoxification programmes is four months. People who depend heavily on drugs say that that could mean 120 crimes in that period because of their desperation. What is being done drastically to cut waiting times for those programmes?
My next question is about residential treatment. The evidence that I have seen suggests that that is enormously productive in helping drug addicts, but the availability of residential places has fallen by some 25 per cent. in the past six years. Why has that happened and what is being done to reverse it?
On financing, I accept that more resources are being put into this problem, which is welcome, but in London 80 per cent. of drugs-related crime takes place in the Metropolitan police area. The Metropolitan police are under severe pressure. How can we ensure that adequate resources are put into enforcement in areas where it is really needed? I saw the figures on using the receipts from confiscation. Although I welcome that policy, given that the trade is estimated to be worth some £10 billion a year in the UK, to seize £3 million from drug peddlers—that is 0.003 per cent., if my arithmetic is correct—is mere tokenism. Why is not more being done, much more energetically, to realise resources from those in the criminal fraternity?
I very much support the Government's strategy. All parties should support the current consensus on resisting de-criminalisation. We should be open to arguments, which is why I support the existence of a royal commission to look at evidence as and when it appears.

Mr. Deputy Speaker (Sir Alan Haselhurst): I call Mr. Paul Stinchcombe.

Mr. Flynn: rose—

Mr. Deputy Speaker: Order. I am awfully sorry to have to say to the hon. Member for Newport, West (Mr. Flynn) that I called Mr. Paul Stinchcombe.

Mr. Paul Stinchcombe: Thank you, Mr. Deputy Speaker, for giving me the opportunity to make just a small contribution to this morning's debate.
My constituency of Wellingborough is not inner city; it is leafy Northamptonshire. It has pockets of deprivation and problem estates, but essentially it is middle England. None the less, heroin is available at £5 a wrap; youngsters hold and hide hard drugs at the behest of older pushers; and young mums come to me for help when their three and four-year-olds pick up needles that junkies have discarded in their front gardens. Local policemen estimate that 80 per cent. of crime in the constituency is drugs related. I do not believe that a single part of this country—a single community, family, age group or individual—is immune from the wreckage that addiction to hard drugs brings.
Many points need to be made in this debate. I hope to concentrate on just one area, which has barely been mentioned thus far. It is the problem—and, indeed, the opportunity—that arises in respect of drugs in prison. I have already shown to what extent crime is drugs related. Between half and four fifths of all crime in this country is estimated to have an association with drug taking. For some, that association is direct and causal—addicts steal simply to fund their habit. For others, the link is more attenuated. In all cases, however, whether the relationship is causal or not, the intervention of the criminal justice process affords an opportunity to deal not just with crime but with drug abuse.
That opportunity is most obvious when people with a drug problem are in custody, not just because they are a captive audience but because they might just begin to question why they are in custody. They might be receptive to the idea that drug taking was part of the reason that they lost their liberty, and they might be receptive to help offered in that regard. Incarceration therefore offers a unique opportunity for us to step in and break a vicious and life-wrecking cycle of drugs and crime.
I am not alone in thinking that, and the idea is not new. As long ago as 1995 a document entitled "Drug Misuse in Prison" was published. In April 1998, a document on tackling drugs in prison was published as part of a so-called "new strategy". They are good documents, which signal a genuine commitment to act. Money has been made available, yet I fear that in implementing the strategies embraced by those documents we are continuing to make avoidable errors.
I do not, however, underestimate the difficulties. We can agree on the objectives. Any anti-drugs strategy for prisons and prisoners must endeavour to achieve three aims: to cut the supply of drugs into prisons; to develop appropriate regimes in prisons; and to ensure that prisoners' needs are met when they leave prison. We can agree on the aims; the trouble is that they are more easily agreed than achieved. Each of those aims raises difficult questions, some of which are hideously difficult. Let us take the first aim of cutting the supply of drugs to prisons.
We could cut the supply of drugs into prisons to an irreducible minimum, but to do so we would have to compel closed visits and intimate searches. By such compulsion, we could stop drugs being concealed—internally or in nappies—by the person visiting, stop drugs being transferred to the prisoner and stop them being secreted internally by the prisoner immediately afterwards.
The difficulty with that approach, however, is threefold. First, it would lead to hideous problems of management in prison. Secondly, it would breach fundamental human rights, not only of the prisoners but of the visitors who have committed no crime at all. Thirdly, and most important, it would threaten the family relationships of the person in custody, whereas we know that preserving those family relationships is the single best way of trying to prevent that person from going back to crime once he has left custody. So, difficult questions arise.
If difficult issues arise in stopping drugs getting into prison, even harder issues arise in developing anti-drugs regimes for people while they are in custody. Many aims must be embraced by an appropriate regime, but we can agree on those aims: to reduce the demand for drugs in prison; to assess the drug-related needs and health needs of prisoners while they are in prison; to develop programmes and wings in prison to meet those needs; to support those programmes with effective drug testing; and to use drug results, especially positive results, not only to penalise inmates but to trigger positive and useful intervention. However, although we can agree those aims, that is not enough—we have to work on the policies, which are difficult to formulate.
In assessing prisoners' health and drug-related needs, for example, what if we should decide to allow needle exchanges in prisons? We allow that to happen outside prison, but if we allowed it in prison, not only health issues but issues of whether we are condoning drug use—and even putting weapons into circulation—would arise. They are difficult issues on which reasonable people can disagree.
There are difficulties also with the issue of drug-free wings. Should we build such wings around incentives, offering a package of Sky television for those who want to go on the wings? If we do not offer such incentives, perhaps the approach will not work. If we do, we encourage people to go on drug-free wings even if they do not want to live in a drug-free environment. Given that we cannot stop drugs going into prison, perhaps, in taking that approach, we would be sowing the ruination of drug-free wings.
There are also difficulties with mandatory drug testing, which we know we need. However, when we have introduced mandatory drug-testing, we are told by every single prisoner that it has led to a switch from cannabis to heroin abuse—simply because cannabis stays in the bloodstream for 28 days, whereas opiates stay for only three days. That evidence may be anecdotal, but it is unanimous anecdotal evidence. It was also backed up by a recent answer to one of my parliamentary questions. It said that, in the past five years, cannabis finds in prison have declined by a half, whereas heroin finds have increased by 300 per cent.
If we discover difficult problems in achieving the first two aims, we shall likewise discover difficult problems in achieving the third—trying to secure an easy and proper transition to care for prisoners when they leave prison. How are we to achieve that when prisoners are moved from prison to prison so frequently that they often end up hundreds of miles from the community into which they will be released? One of the saddest facts of all is that, even when we do reduce inmates' drug dependency, we release them into their communities without aftercare and therefore put them at huge risk. The risk is not only that


they will take up their habit again, but that because their tolerance to drugs is diminished, they will overdose and die.
There are horribly difficult problems, but that makes it all the more important to take the easy steps first—to do the simple things and to get them right. With the greatest possible respect to Ministers, I must say that I genuinely believe that we are failing to do that now and that we are making basic, avoidable and expensive errors.
I shall take the three aims in turn and give my hon. Friend the Minister a few simple examples. On cutting the supply of drugs into prison, we know that we cannot have compulsory closed visits. However, we can have centrally funded drugs dogs.

Dr. Iddon: Does my hon. Friend admit that drugs go into prisons not only by the front door, but via the back door?

Mr. Stinchcombe: Drugs go into prisons in many ways. Sometimes they are thrown over the fences—in crisp bags, for example—but they go in predominately via visits.
I have said that I do not believe that imposing closed visits is the answer. One thing that we could do, however, is use centrally funded drugs dogs, active and passive, in prisons. An answer to a parliamentary question that I tabled a week or so ago states that training and maintenance costs for a passive dog are £3,321, and for an active dog £3,000. The annual refresher is £1,000, and the average annual cost of keeping a dog is £2,088. Therefore, it is not hideously expensive.
The hon. Member for Congleton (Mrs. Winterton) tells us that we have to look for resources, but drugs dogs are not expensive. Yet 40 of our prisons in the prison estate do not have access to drugs dogs exclusively and full-time. That is absolutely ridiculous.
The second aim is to develop an appropriate regime in prison. We persist in a mandatory drug-testing programme built around expensive laboratory tests, targeting 5 per cent. of inmates each month. That means that we seek to test each inmate once every 20 months—once every 600 days. However, opiate traces disappear after three days. Therefore, the current regime is a completely useless endeavour if we are trying to discover the extent of drug use in prison. Those are not simply my words, but words that, just this week, were agreed by Sir David Ramsbotham in evidence to the Select Committee on Home Affairs.

Mrs. Ann Winterton: I commend the hon. Gentleman on what he is saying. Is he aware that it would be better practice if the whole prison population were tested at one go, and that that could be done quite easily with a urine test and litmus paper? Slightly dodgy tests could be subject to the more expensive test. Such testing would ensure that we knew the real state of drug abuse in the prison population. Currently, we have not the faintest idea of the real situation.

Mr. Stinchcombe: I agree with every single word of that. The laboratory test costs £70; the litmus paper test costs 50p. For each lab test, we could have 140 litmus paper tests. Currently, with laboratory tests, we can afford

to test only once every 600 days, but with litmus paper tests we could afford to test every four or five days, thereby breaking into the three-day cycle of opiate detectability. It is an easy strategy to adopt.
What about cutting the demand for drugs in prison? The hon. Member for Beckenham (Mrs. Lait), who has now left the Chamber, said that, outside prison, drug taking is sometimes caused by people not having busy and fulfilled lives.
A couple of weeks ago, I visited Winson Green prison, where 70 per cent. of the inmates are locked up for 23 hours a day. There is no education, no work and no exercise—just a cell, every day, virtually all day. No wonder prisoners turn to drugs—not uppers, amphetamines or ecstasy, but heroin. They do so simply to get through the day. They do so because they are in a prison which was not designed to hold them long term. It was designed for remand prisoners.
We are holding prisoners inappropriately in the existing prison estate, and we are causing some of them to go on to drugs although they were drug-free when they were put in custody. We are making them into addicts when we should be intervening to stop them being addicts.
It will be difficult to solve that problem, but the first step is simple. We need a fundamental rethink of how we use the existing prison estate. It is a question not just of building more prisons but of looking at how we use our existing prisons. Prisoners must be kept in local prisons in their own communities; remand prisoners must be kept in remand prisons; in each area there must be opportunities for work and education available in prison; and we must have within each area consistent, high-quality, needs-based drugs counselling and detoxification. If we do that, we make it possible to have synchronised care and support once the prisoner leaves prison to go into his own community.
These are difficult questions, but there are simple answers to some of them. It is appalling that, even now, we are failing to come up with those answers and to take appropriate steps.

Mrs. Cheryl Gillan: The debate today is a small triumph for my hon. Friend the Member for Congleton (Mrs. Winterton), who has requested a debate on drugs on several occasions from the Dispatch Box. I am delighted that the Government, after two years in office, have finally taken the topic seriously enough to devote a morning to it. I believe that there should be an annual debate on drugs.

Mr. George Howarth: It was my suggestion that we have this debate—to which my right hon. Friend the Minister for the Cabinet Office agreed—and a proposed annual debate was part of a wider suggestion.

Mrs. Gillan: My hon. Friend the Member for Congleton requested this debate at business questions on a number of occasions, and I am delighted that the Government have responded. I hope that the Minister will confirm that the Government, while they are in office, will come forward with a proposal to hold a debate on this topic in Government time every year between now and the general election. That would be welcomed on both sides of the House.
Apart from the glaring differences between myself and some of my hon. Friends, and other hon. Members—for example, the hon. Member for Bolton, South-East (Dr. Iddon), who expressed his views quite bravely—there is a lot of common interest and shared hope in this House concerning drugs because of the enormity of the problem.
It bears repeating that about half of those under 25 in this country have used illegal drugs. At least half of all recorded crime in this country has a drug-related element. There are probably around 200,000 addicts in the United Kingdom, and the annual costs of the most serious drug misusers alone are well over £4 billion, which is an enormous drain on the economy of the UK.
The topic is complex, and we can see that it ranges from drugs in prisons to the international situation, from children to the amount of money that is spent on tackling the problem once an addict is on the books. It is true that there needs to be a vast amount of co-operation between politicians, police, parents, teachers, Customs and Excise and the armed forces. No Government have come up with the solution to the problem that they face, but we have a chance to air some new ideas.
The hon. Member for Wellingborough (Mr. Stinchcombe) proposed some useful suggestions in a well balanced and well-thought-out speech, and I hope that the Minister will consider them carefully.
For our young people, this is a most important problem. The last time I spoke on drugs in this House I was responding to an Adjournment debate initiated by the hon. Member for Nottingham, North (Mr. Allen) on the DARE project in Nottingham, which has been mentioned today. I am particularly keen on the DARE project, which educates youngsters between the ages of nine and 13 on the dangers of drugs. We need to get to our children long before they are in danger of taking drugs.
I am a smoker, but I stopped smoking in March. I look on myself as taking a rest from smoking—it will just be longer between cigarettes. I can tell the House how difficult it has been for me to stop smoking, but I cannot imagine how difficult it must be for a young person to give up drugs.
We must ensure that the Government spend a certain amount of their resources on educating people and getting to them before the drug dealers and marketers of this pernicious trade. I would always support the allocation of extra resources to that end. I asked the hon. Member for Nottingham, North about the DARE project last night and he said that it was still thriving in his area, but I would like to hear from the Minister what further resources the Government may put into the project and how it is spinning out around the country.
The drugs industry is a vast international industry and the statistics are frightening. It probably represents 8 per cent. of all international trade. It is comparable to the gas and oil industry. In an excellent article in The Independent on the world drugs trade, Diane Coyle, the economics editor, said that the drugs business is not only the third biggest economy in the world but could be starting to catch up with the United States as the leading player in the world economy. That should strike horror into all our hearts.
The United Kingdom has estimated that drugs cost us about £4 billion a year. That is 1.2 per cent. of gross domestic product, so if one multiplies that by all the

economies in the world, one begins to think that drugs represent one of the most severe problems faced by Governments today. I hope that I do not exaggerate, but considering that drugs destroy families and communities and divert resources from other areas of need, major international action is needed. What have the Government done on the international stage?
Several hon. Members have highlighted harm reduction as an approach to the problem. The hon. Member for Bolton, South-East went even further; I believe that he favours the legalisation of all drugs, albeit in a step-by-step process. I disagree with him fundamentally. I believe that the philosophy of harm reduction has caused many problems, as evidenced by the half-baked experiment in Holland.
Mary Brett, who works at Dr. Challoner's grammar school in my constituency, has been at the forefront in the fight against drugs among our school children, and she provides me and other hon. Members with material from time to time, to keep us up to speed with the views on drugs. She has been especially worried about harm reduction theories and the way in which people's attitude to drugs is starting to soften. Holland is often cited as a great example of that.
The effect of the Holland experiment is not confined to that country but extends to the rest of Europe and throughout the world. Customs officers in the United Kingdom, France and Belgium who said that Holland had become the drugs capital of western Europe are absolutely right. Customs and Excise in the United Kingdom estimated that 80 per cent. of the heroin seized in the United Kingdom either passed through or was temporarily warehoused in Holland.
The Paris police estimate that 80 per cent. of the heroin consumed in the French capital comes from Holland. According to French customs officials, there is an explosion of drugs coming into France from the Netherlands.

Mr. Brian White: Will the hon. Lady tell the House how much of that traffic through Holland is the result of the pre-eminence of Rotterdam as a major port?

Mrs. Gillan: I do not have those statistics to hand, but I would be willing to discuss them with the hon. Gentleman. Once I have looked at the source material, I shall provide him with it. I shall not give him statistics off the top of my head when I do not have the material to back them up, but I am using material from accredited sources, such as Customs and Excise.
The article that appeared in Foreign Affairs, volume 78, No. 3, written by Larry Collins, is recommended reading for the hon. Gentleman. It records the remarkable candour of the Amsterdam police commissioner, Jelle Kuiper, who said:
As long as our political class tries to pretend that soft drugs do not create dependence, we are going to go on being confronted daily with problems that officially do not exist. We are aware of an enormous number of young people strongly dependent on soft drugs, with all the consequences that has.

Mr. Flynn: Will the hon. Lady explain why every political party in Holland, including the Christian Democrats, the liberals and the socialists, are in favour of continuing with the drugs policy?

Mrs. Gillan: No; I am not a member of any of those parties, so I cannot explain to the hon. Gentleman—but I can give him another international example of somewhere that changed its mind.
In 1975, Alaska decriminalised the use of cannabis at home and in other private places. In support of decriminalisation, it was argued that use would not increase, that cannabis was not a gateway drug, and that crime would decrease, because cannabis was a "peacemaker" drug. The latter argument persuaded the police to back decriminalisation.
In 1989, the United States national survey of high school seniors found that the use of marijuana in the past month had been 17 per cent. nationally, but 45 per cent. in Alaska. Between 1988 and 1990, an enormous number of Alaskans were committed to state-funded treatment programmes, with marijuana and hashish as their prime substances of abuse. Trafficking increased too, and the heavy increase in health and social costs, as well as the increase in the use of other drugs and the escalation of crime, led to a referendum in 1990 which, with police support, rescinded the law. That is a matter of fact, which graphically explains how an experiment in legalising cannabis proved disastrous.
I am worried that the Government seem to be taking us down the road of closer and closer harmonisation with Europe. I would like the Minister, when he replies to the debate, to assure the House that he has no intention of harmonising this country with Holland in that respect, and that there is no danger of cannabis coffee shops appearing on our streets. I want a firm assurance that integration with Europe will stop at that point, if nowhere else.
My hon. Friends the Members for Congleton and for Beckenham (Mrs. Lait) both mentioned Customs and Excise. In the international fight against the drug traffickers, Customs and Excise are in the front line. I meant the Minister to take seriously what I said in my earlier intervention—he must give an assurance to the House that there will be no cuts in Customs and Excise.
Customs and Excise staff work in difficult conditions, and their international co-operation and intelligence services are extremely valuable. Indeed, their intelligence operation is looked up to throughout the world. It has good results, and its annual report for 1997–98 gives an overview of its performance on drug trafficking and how it has achieved its targets, whether in preventing the importation of drugs or dismantling smuggling operations. The amounts realised against confiscation orders far exceeded the targets that had been set. All the targets were achieved or exceeded, bar one. I hope that the Minister will reconsider those targets and increase them, and also increase the resources for achieving them.
My hon. Friend the Member for Beckenham mentioned crop substitution. Some years ago, I visited a company in Penn in my constituency in Buckinghamshire called Agropharm. It produces insecticides from chrysanthemums which are used as insect repellents and in the formulation of human head and body lice shampoos and lotions. Pyrethrins are natural products and the company emphasises the use of organic products. The

insecticide is used on large gatherings of people who may be at risk from disease and, as a naturally occurring compound, it causes no problems. It is an ideal substitute for organophosphate compounds, which have been widely criticised and are in the news again this week.
The chrysanthemum can grow in similar conditions to the poppy plant. We know that one of the problems in drying up the drugs trade is the amount of income that is derived from the sale of the poppies by poor families in remote areas. How much research and resources are put into examining the possibility of crop substitution? Agropharm has experienced shortages of the raw material it needs to fill its orders and has to buy chrysanthemums from abroad, but I suspect that few, if any, resources are put into crop substitution. Will the Minister undertake to devote resources to crop substitution and does he agree that crop substitution has a role to play in the war against drugs?

Dr. Iddon: One of the main drugs in use in clinical practice is morphine, especially for terminal patients. It is a complex molecule that is too difficult to synthesise. Unfortunately, it comes from the opium poppy. Has the hon. Lady considered that point? I spent 12 years on research into non-addictive analgesic drugs as replacements for morphine. That is the difficulty with eradicating the opium poppy.

Mrs. Gillan: I know that the hon. Gentleman is a distinguished chemist, and I take his point. The poppy can be grown for medical purposes, but the quantities grown at the moment far exceed that required. Therefore, it is not unreasonable to examine the possibilities of crop substitution to help those families who are tied to the drugs barons in south America, for example. I hope that the hon. Gentleman will accept that I do not advocate the total destruction of the poppy and that I acknowledge the benefits that come from its derivatives. However, I want the option of crop substitution to be examined seriously, especially by the Government, given the worldwide shortage a couple of years ago of the raw material needed by Agropharm.
Politicians should not always be at each others' throats. There is a convention in the House that all parties support the Government of the day when there is a war. The war against drugs is very much that—a war. Despite personal differences of opinion about the best way to conduct it, it is right that there should be a concerted effort across the House, engaged in by successive Governments and Oppositions, to tackle the problem. I hope that the Minister will continue that effort.

Mr. Paul Flynn: The most dangerous killer drug in Britain is tobacco, and the drug that involves more people in crime—and especially in crimes of violence—than any other is alcohol. Our children and grandchildren are 100 times more likely to die from the use of legal drugs than from illegal drugs, and they are 10 times more likely to die from the use of medicinal drugs than from illegal drugs. Paracetamol kills three times as many people as heroin. The worst examples of drug abuse in Britain are in care homes for the elderly, where neuroleptic drugs are vastly overused. There are many terrible examples of drug abuse, but this morning's debate concentrates only on illegal drugs.
Are the illegal drugs the most addictive and dangerous of all? They are nothing of the sort. Some are far less addictive and dangerous than others that are generally available. We concentrate on the illegal drugs for one reason—prohibition, from which derive all the dangers, the crimes and the profits associated with drugs.
One optimistic development took place yesterday, when the 100th Member of Parliament signed early-day motion 651 asking for the legalisation of cannabis for medicinal use. That is an enormous leap forward: six years ago, only 13 hon. Members signed an almost identical motion. The debate is developing, and this is by the far the best discussion of the matter in the House since 1987. The Government appear to have decided that cannabis will be allowed to be used for medicinal purposes, a proposal supported by the hon. Member for Twickenham (Dr. Cable). It is not a question of if, but of when. I think that that is quite right.
Speaking as a chemist, I do not want to wait for five or 10 years or however long it takes before it is determined which ingredient in cannabis is beneficial. Such a result might not be confirmed in my lifetime, but natural cannabis has been used and trialled for 3,000 years and by tens of millions of people. Any serious side effects would have been discovered centuries ago.
People who suffer the spasms of multiple sclerosis find relief only in the use of medicinal cannabis. The same is true for people suffering the awful side effects of chemotherapy. They feel nausea for days, and it is so debilitating that they no longer want to live. Many of the chemical drugs that they take mimic the effects of secondary cancer. A House of Lords Committee has recommended that cannabis should be treated in the same way that morphine and heroin are treated—that it should be allowed to be prescribed under certain conditions.
Carol Howard came to the House to make hon. Members aware of the plight of her daughter who, at the age of 28, was dying of cancer and who wanted to communicate with her mother in the precious few days that were left to her. The chemical drugs that alleviated the effects of chemotherapy had left her in a confused state and she could not communicate. Using cannabis, however, she was lucid. Her mother told me that she got cannabis on the streets for her daughter. Which of us would not have done the same for a loved one? Yet, constantly, Governments refuse to act.
A Bill will come before the House on 23 July. It makes no great change to the law. It could be enacted overnight, providing what the House of Lords Committee asked for.

Mrs. Ann Winterton: The hon. Gentleman makes his case with great passion, but will he comment on the scientific evidence? In 1992, the National Institute for Neurological Disorders reported that no scientific studies had shown marijuana to have had beneficial effects on multiple sclerosis patients. In 1994, research by Greenberg et al. concluded that
marijuana smoking impairs coordination and balance in patients with spastic MS.
In addition, a National Cancer Institute report stated that newer anti-emetic drugs, such as Ondansetron, had been shown to be more useful than THC as a first-line therapy.

Does the hon. Gentleman agree that scientific experiments have not proven his case? If they had, the Government would have listened.

Mr. Flynn: I can give examples going back to the people who built the pyramids, who recorded in their hieroglyphics that they used cannabis for eye problems. They did not know what it did, and nor did we until about 20 years ago, when we discovered its effect on pressure on the inner eye. The hon. Lady offered three examples, but I could give her 100. Better still, I invite her to meet a group of people who came to the House a while ago. Most of them were in wheelchairs. Some said that they could not have a night's sleep without cannabis. One person had an aching arm for which everything had been tried, and nothing eased the pain but cannabis.
Is the hon. Lady simply saying to those people, "Sorry, we have rules and regulations and you must wait until scientists come out of their labs in five, 10 or 20 years from now"? Is she telling them that in the meantime, they must carry on suffering? Are we telling those people that we will put them in prison? Two such people are in fact in prison for cannabis use.
The hon. Lady mentioned smoking, and that raises another problem. People who are suffering must buy their cannabis on the criminal market. They do not know how pure it is. They do not know whether it is contaminated. They do not know its strength. They must also use it in the most dangerous way possible—by smoking it. If cannabis were legalised, it could be taken in perfectly safe forms—a tincture, a patch or an inhaler.
My cause is a humanitarian one. Tens of thousands of people suffer. In addition to the pain of their illnesses, they must suffer the constant anxiety of knowing that they might go to prison for using their medicine of choice. I appeal to the Government to change their mind and to allow the private Member's Bill to pass on 23 July.
I have a scientific background, and I am interested in all drugs. I have spoken many times about medicinal drugs and others. Our society is obsessed with drugs, and future generations will judge us for it. We believe in the myth that every moment of boredom, grief or pain can be solved by resort to a drug. We do ourselves great harm by that belief. I have never used an illegal drug, and I never will. I have not used a medicinal drug in 25 years. I am very much opposed to the use of drugs.
The major problem is prohibition. There is a shared feeling in the House that we do not face up to the issues. With one exception, I am the only Member who has spoken in every drugs debate since 1987, and I have heard the same themes from both sides of the House. I have heard complacency. I have heard expressions of shock. I have heard: "Isn't it terrible, and we don't know what to do." In 1989, the then Minister of State announced 40 new schemes. We are full of schemes. He said that his policy was a striking success and, to our shame, the then Opposition congratulated the Government, giving them an alpha plus for their work. It is quite amazing that the Minister of State said:
We can take some comfort…from the fact that heroin has moved towards its peak".—[Official Report, 8 December 1989; Vol. 163, c. 593.]
We were all back here again in 1993, when a new Minister of State announced 200 new anti-drug projects in London alone, which the Government would evaluate


with careful research. In 1995, the Minister of State said that education policies were working and effective, as were publicity campaigns. He said that they would have a real effect on young people and that the central drugs co-ordination unit had performed massively successful work. After the 1989 debate, drug use and drug deaths increased, as they did after 1993 and 1995 debates.
We were here discussing this subject again in 1996—not long ago—when we heard about a strategy for substantially different benchmarks to assess programmes. It was said that there had been excellent work with all concerned, especially all the politicians, and the Opposition agreed. The previous year, we had had something new: drug action teams with drug action plans. It was said that the solution was in our hands.
That is what has happened every year since I have been in this place and hanging over this House, like a great accusation, is the fact that in every one of those years more people have died and more lives been ruined through drugs. Why? We conveniently say that it is the wicked drug traffickers and those who grow drugs in far-away countries who are responsible. We must look to ourselves and ask what is our responsibility.
Why has the debate bypassed this place as far as those on the Government and Opposition Front Benches are concerned, when it has even got as far as the editorial in the Daily Mail, which has said that the Government's policies are mere "empty window dressing" and that it is time for us to take the risk of considering decriminalisation? We are neglecting our job here as Members of Parliament to find new policies.
I do not want to be rude to the hon. Member for Congleton (Mrs. Winterton), who is speaking for the Opposition. Clearly, she is at the embryonic stage in developing her views on the subject if she takes her feed from the internet. However, I will have to withdraw my invitation to go to Amsterdam with her. I said that I would never take an illegal substance, but her Mary Poppins approach might well drive me to it if I had to spend a few days with her. She should have a long conversation with the hon. Member for Rutland and Melton (Mr. Duncan), who has said that he wants to pursue the policies suggested by my hon. Friend the hon. Member for Bootle (Mr. Benton). There are Conservative Members who are willing to think anew on this subject.
Many matters have been mentioned in the debate. I have the great joy of serving in the Council of Europe. I am a member of its committee to deal with drugs and I am in regular contact with people from all the countries, in particular Holland, Switzerland, Italy and Germany, where all those changes have taken place.
Those on both Front Benches should go to Holland. I beg them not to read the propaganda on the internet and what the American drugs tsar has said, but to consider the experience of the group that was sent to Holland by Fulcrum Television. It was the equivalent of a citizens' commission—a television commission. It comprised eight people—a broad section of society—who went to Holland without any vested views either way. In fact, the majority of them were against decriminalisation when they started. They investigated and went to jails. They met people from a cross-section of society, met the police and read the

literature thoroughly. They interviewed Members of Parliament, both for and against. It was a thorough three-month investigation.
The group spoke to the Christian Democrat mayor of Amsterdam and gave him a list of the things that this Government have said about Holland—they are exactly the same as the untruths told by the previous Government. That conservative mayor of Amsterdam said that every one of those claims was nonsense.
In Holland, the two markets have been separated. The great achievement of the Netherlands is that the use of heroin has been reduced, and for good reason. The Dutch did that by de-glamorising cannabis, which is the first stage—people talk a great deal about the step from one drug to another. In this country, we know that cannabis has a great attraction. The figures show that the majority of young people have used it. In Holland, use is down to about 3 per cent. and the reason is that it is boring and unglamourous. Where is the thrill in going to a café with one's grandmother and using cannabis? There is no fun in that.
Fun is part of the attraction of cannabis for the young. I have more up-to-date figures from the Dutch embassy than those of my hon. Friend the Member for Bolton, South-East (Dr. Iddon)—I am not being party political. In 1980, the average age of heroin users in Holland was 28; it is now 44. It will become a geriatric problem; young people are not moving towards heroin, so the total number is going down. If the hon. Member for Congleton does visit Amsterdam, I suggest that she goes to a needle exchange in the Nieumarket—a marvellous place where they dealt with 500,000 needle exchanges five years ago. The number has gone down to a third of that figure, because the use of heroin has gone down. I suggest that the hon. Lady sees for herself what is happening in Holland, instead of believing the propaganda.
We have heard a great deal about education. I appeal to anyone to show me any drug education policy that resulted in decreased drug use. There was a celebrated programme in Wales called Smokebusters; it was a highly intelligent, cleverly designed programme to persuade young people not to take up cigarettes. It went on for four years. During that time, the largest increase in young women smoking occurred in Wales. It was larger than anywhere else in Europe—more than 50 per cent.—and it coincided with that campaign.
A further example of the futility of drug education programmes is shown by what happened in America in the 1950s. They decided that there were drug problems in the great cities, so what did they do? They sent out teams to the plains to tell people not to do drugs. The teams were made up of young people—young hippies—who had been through everything; they had been through drugs and had had a terrible time. They were attractive role models who went out with their guitars to talk to adolescents; they said, "You mustn't do drugs because they're wicked—yeah! You mustn't do drugs because they're dangerous." That is exactly what young people want. They all know that they are immortal—they are going to live for ever. Being young is about risk taking. As those drug education teams moved from town to town, hard and soft drug use followed them as surely as night follows day. That was the US experience.
In this country, we have made a great fuss about Operation Charlie. I thought that it would be a wonderful scheme because so much emphasis was placed on it;


it was an entirely British scheme that would prove that drug education worked. Even after a series of parliamentary questions, it was difficult to find out exactly what the operation was. Would it be for 25 years and involve teaching tens of thousands of children, beginning when they were young, so that when they became adults they would not use drugs? No, no; it involved 44 children. They were given a lesson of one hour a week for 38 weeks a year—not even for all 52 weeks. Four years later, that group was compared with one that had had no lessons; there was only a slight difference in their opinions. It will be another 20 years before we know whether that programme was any good. "Charlie" means chemical abuse resolution lies in education; that title shows that the result of the research was decided before the research began.
In the House, we suffer from the shared myth that prohibition works and that it reduces drug use. All the evidence shows the opposite. In America, the prohibition of alcohol produced—among other things—a crime empire. Furthermore, it meant that the alcohol on sale was the most damaging form; people were drinking distilled spirits. It is the same with all the illegal drugs in this country at present; we are using all the most dangerous forms, with the additional problems that they are adulterated and sold in an uncontrolled market.
We can do something about that. Earlier, the Minister for the Cabinet Office asked whether people really believed that the market could be collapsed. That is the only way to solve the problem. The only way to reduce drug harm and to reduce the market for drugs is to collapse the black, illegal market. How do we do that? We replace it with a regulated, licensed, policed and controlled market. The harm will not go away overnight—of course not—but at least there will be some controls. If the illegal market sells a drug to a child or a schizophrenic, it is the same offence as selling the drug to a well-balanced 50-year-old. If we had a legal market like the one in Holland, people who sold hard drugs along with soft drugs would be closed down, as would those who sold drugs to minors.
A legal market offers a way of controlling supply. Overnight, we could effect change on an army of young people. People speak contemptuously of drug dealers, as though there were only a few of them, but there are hundreds of thousands of young people who are part of the pyramid—kids selling drugs to school friends, older children selling them to other children. Overnight, we could change those young people who are drug dealers, many of whom are on benefits and are registered as unemployed. We could change them from being criminals and scroungers to being business men—surely the Opposition can understand that. We could have our drugs in order and we could say which are the most dangerous to society.
Sometimes I feel like addressing my colleagues here, with some justification, as right hon. and hon. drug users, because there is a strong note of hypocrisy in our utterances on this subject. In this place, with all its bars, it is common to see Members from both sides of the House with a glass of whisky in one hand, a cigarette in the other and a packet of paracetamol in their top pocket, denouncing young people for using drugs. Since I came here, the majority of the premature deaths among Members of Parliament have been drug related: those

drugs are alcohol, tobacco and, in one case, medicinal drugs. We cannot tell young people that their drugs of choice are necessarily harmful or the worst possible.
We have a debate such as this every year and there is a fair degree of cross-party consensus, but we are moving away from public opinion. The public know that almost nothing that we have done has worked and that nothing that we will do in the next two years will work. To have a 10-year programme is to evade responsibility and to escape any sort of scrutiny, because in 10 years time, the drugs tsar will have retired and my right hon. Friend the Prime Minister will be Lord Sedgefield. By the end of this Parliament, the Government will be in the same position as every other Government for the past 30 years: when they leave office, there will be a greater degree of drug use and a greater number of drug deaths than when they entered office.
The change must be made here—we have to face up to our responsibility. Now, we are saying that we will not consider any alternative; we will not consider decriminalisation, even though it has worked elsewhere; nor will we consider the example of Switzerland, where crime related to the use of injectable heroin has been cut. We will not go outside this place and look at what other people have done; instead, we will carry on in the way we always have done, because it is comfortable. If we continue on that path, in 10 years time, there will have been at least 1,000 deaths among young people that might have been avoided.
When we see young people's lives ruined, we say that we will carry out a few more reviews and introduce a few more schemes. When we see families broken up in a terrible way, we put off decisions for years spent finding out whether this approach or that one works. When we see the ruin of a whole generation of young people, our answer is to promise that we will consider the problem a long time from now. We are failing in our duty and, if avoidable deaths occur, the responsibility must be shared among us. The responsibility for not facing up to alternatives rests firmly on this House. If more drug deaths occur and drug addiction spreads, the responsibility will, rightly, be laid on our shoulders by people outside this House.
I have been saying this since 1987. I have been true and right in every one of the years since then. The Government and the Opposition have been wrong.

Mr. Oliver Letwin: I am grateful to the hon. Member for Newport, West (Mr. Flynn) because he has brought my comments into starker relief than might otherwise have been the case. The whole debate has been extremely interesting and I have learned a great deal, for example, from the hon. Member for Wellingborough (Mr. Stinchcombe) who spoke about prisons.
There has been a common theme, evident even in the speech of the hon. Member for Newport, West, that everybody seems to disapprove of drug use. The hon. Gentleman and those who agree with him say that the best way to get rid of drug use is to decriminalise it, whereas others say that the best way is to keep it criminal and take some measures.
This is a most interesting phenomenon. Everybody disagrees about one level of the question but agrees about another level. I do not think that that represents the state


of mind of either the House or the country. I think that we face a much more fundamental question: do we disapprove of drug use? The House must wrestle honestly with that question and, until we do so, we will not be able to decide the second question.
I do not accept the arguments advanced by the hon. Member for Newport, West and other hon. Members that decriminalisation is likely to lead to less drug use. None of us have any way of telling that. As the hon. Member for Twickenham (Dr. Cable) pointed out, the laws of economics suggest that if the price falls, demand will increase. The evidence on the use of the drugs that the hon. Member for Newport. West fears most—tobacco and alcohol—is that because they are decriminalised, they are widely used.
I admit that they are not robust arguments, but my instinct—which I suspect is shared by most of the country and of the House—is that if illegal drugs are decriminalised, their use will, on the whole, tend to increase rather than decrease. That is certainly the view of those concerned most closely with the problem such as the drug advisory service and the police, many of whom are very sympathetic to drug users, but not drug pushers, in my constituency.
We should accept that as a hypothesis. We must then ask the really hard question. Many of us disapprove of substances when they are used to excess. Some people—I do not count myself among them but they certainly include the Secretary of State for Health and his primary Ministers—disapprove violently of drugs, such as tobacco, when they are used at all. Why do we not criminalise those drugs and criminalise the drugs that are currently illegal? Can we defend that position?
I pose that question partly to myself but also to my hon. Friends and to Labour Members who consider themselves to be proponents of liberty. How do we feel competent—as a House and a Parliament—and how did our predecessors feel competent to prohibit the use of such substances when no one suggests that their use amounts to an imposition by one upon another? It is not like driving a car and knocking someone down; it is not like murder or like theft. If I take drugs, I may harm myself but I do not directly harm another. I am referring not to drug pushing—that is another matter—but to using. It is self-harm. I may destroy my life, but how do we feel competent to decide that we should pass laws to prevent people from harming themselves? Should we not also pass a suite of laws to prevent people from harming themselves in other ways?

Dr. Iddon: Bungee jumping?

Mr. Letwin: Indeed. Arguments of that variety could be advanced.
I have wrestled with this question for the better part of the past couple of decades since I started thinking about it in a juvenile way as an undergraduate. I have always wondered why this is so. Being rather pusillanimous about it and not being inclined to destroy my life in this particular way—although I do so in other ways—the question has never been at the top of my intellectual agenda. However, I have always worried about whether there was a proper justification for preventing the use of some drugs.
I have come slowly—and perhaps wrongly—to the conclusion that there is a justification. I think it is worth exposing that reasoning briefly—in three or four minutes—not least because I will be interested to hear, in this and in subsequent debates, whether others share my view. Unless we have a robust justification, I am sure that we should not criminalise these activities. We should start from the point that, prima facie, activities that do not harm others should be allowed and we should ban them only if we have a robust justification for so doing.

Dr. Cable: Does the hon. Gentleman agree that the House has grappled in the past with this problem with less difficulty than he is experiencing? For example, it has long been agreed that we should require individuals to protect themselves by wearing seat belts because that is in the best interests of their families and of our socially available health system.

Mr. Letwin: I am grateful to the hon. Gentleman for making that point, because I am a profound opponent of the law on seat belts and, for reasons that I shall expose in a moment, that is entirely consistent with my views on drugs. The hon. Gentleman raises the question in exactly the form in which it first presented itself to me. I was an undergraduate when the noxious law on seat belts was passed. I knew that I hated it, and I still do. I wear a seat belt, even in the back seat, and I did so before it was law. I wear a crash helmet when I cycle, but I have always thought that a law requiring cyclists to wear crash helmets would be noxious.
I am absolutely clear that the prima facie case is that things should be allowed if they do not harm other people. I wholly reject the argument that things should be banned if they cause a cost to the national health service. If we accept that argument, tyranny beckons. Instead, measures should be taken to ensure that people who choose to act in certain ways have to pay a higher insurance premium or so on.
I utterly reject the argument for banning things. How, then, can I possibly defend the laws on drug use? The question is clearest if we consider the contrast between drugs that are illegal and drink. There is no doubt that drink is the most difficult case. One can drink to excess and, in doing so, one threatens society in many respects. I am not referring only to drinking and driving—that is a special case. Yet we permit drink, but we do not permit drugs. That is the most acute form of the question, "How do we justify allowing people to drink?"
If we are to justify it, we must start with a concept of the kind of society in which we want to live. We must be willing to argue—it is not easy to do so—that we want to live in a society in which people are able to engage in civilised conversation with one another and to engage in specifically human activities. I refer to cultural activities of a kind that animals cannot engage in and that cannot be engaged in by people who are in a state that prevents them from exercising their minds, as we are able to do in this House. In other words, we must have a concept of a human existence that is beyond merely existing.

Mr. Flight: Beyond the animalistic.

Mr. Letwin: As my hon. Friend says, beyond the animalistic.
To my mind there is no doubt that a person in a state of extreme drunkenness and a person in a state engendered by probably all the drugs that are illegal are not in full possession of their faculties. To justify the desire to eliminate drugs, one must have, first, the concept of a person in full possession of his faculties and, secondly, a doctrine that we want to live in a society in which other people are in full possession of their faculties. That is a kind of imposition or tyranny. I espouse, as one must be willing to do if one wants to justify the elimination of drugs, a doctrine that says it is not enough to let people lead their lives as they like because we want a society in which people have to lead their lives in such a way that we are enable to engage in a continuous, civilised conversation with them when they are in full possession of their faculties.
That means that there is a difference between drink and illegal drugs. When people have a bit to drink, which is mostly what they do, they are in full possession of their faculties. Ultimately, we must draw the distinction between substances whose very purpose is to make people, effectively, drunk, and those which, if occasionally abused, make people drunk. We must, therefore, have not only a concept of a society that consists of people in full possession of their faculties, but a concept of substances that are designed precisely to produce the opposite result. Without those two premises, we cannot justify to ourselves the continuation of the illegality of those substances.
The question is whether we have the confidence to make those assertions. I have that confidence, but I am not sure that the rest of society does. If we do, we can continue to ban those drugs. If we cease to ban them, they will become more prevalent, and we should accept that result if we are to accept a doctrine of pure Millian liberalism, but we should not accept it if we are willing to espouse, as I am, the doctrine that society consists of more than atomistic individuals, wandering around being allowed to lead their lives at whatever level they choose. We must have that cultural self-confidence if we are to espouse that argument. My distress is that on both sides of the House—this is not a party-political point—and more widely among political commentators, there has not been a willingness to make that argument.
So, the debate goes on in surreal terms. One side says that in order to keep substances from spreading, they must remain illegal, while the other side says that the spread can be stopped by decriminalisation. I do not believe the argument or that the proponents believe it. Underneath it, those who want to maintain illegality fear to say that they have a reason for doing so, because they are not sure that others will believe it, while those who want to decriminalise do not really believe that that will stop the spread—they really believe that there is nothing wrong—but are afraid to say so because they are also not sure whether others will agree. We must get out in the open whether, as a society, we have the confidence to try to stop these things that diminish our humanity. From that, much else about the rest of our social policy will flow.

Mr. Jon Trickett: The majority of people in my constituency do not have to go through the philosophical agonising of the hon. Member for West Dorset (Mr. Letwin) to decide that drug taking is a nefarious activity that destroys the social fabric that binds

our common humanity. Nor does one philosophically need to be a socialist who believes in individual liberty, such as myself, to follow the kind of libertarian arguments that have just been deployed. What I, most people in Hemsworth and—I think—most British people believe is that Government action in entering human affairs to prevent activities that are plainly evil and destructive of social fabric, as much drug taking manifestly is, can be benign.
I want to give a voice to the concerns of many of my constituents who are facing a rising tide—almost a cancer—of drug taking, as are many communities in former coalfield areas. If one believes, as I do, that Government action can be benign and that it can try to remedy social evils such as drug taking, it is right that the Government should take such action. I think that the Government have it broadly right.
The strategy that the Government have described, about which we have heard today, talks of an integrated approach across all Government and non-governmental agencies. It talks of targeting, by which we can measure the achievement or non-achievement of our objectives for reducing drug taking. It identifies the multiplicity of factors that lead to the rising menace of drug taking in our communities. Above all, it commits additional resources. I know that people in my area will very much welcome the Government's announcement that they intend to spend an additional £217 million over three years on combating the drugs menace. There will be particular pleasure in learning that we intend to use resources recycled from convicted drug dealers. That is an especially welcome announcement.
The scale of drug taking, as every hon. Member has said, is growing exponentially. The Department of Health and Government agencies have produced a range of different measures of the increase. Some further work needs to be done, but, whatever index one uses, one will discover that over the past five years or so there has been an estimated 40 per cent. to 70 per cent. increase in, for example, heroin addiction—30,000 new agency episodes between 1993 and 1998.
In Wakefield, the district within which my constituency lies, only 52 people were referred with heroin problems in 1993-94. By 1997-98, 1,800 people—a huge increase—had been referred due to heroin problems.
In WF9—a postal district of Wakefield that forms only part of my constituency—an agency called Dashline is helping people with heroin problems. Some 2,000 needles are issued every month to people with heroin problems in four or five villages in my constituency. In 1997–98—a single year—226 people in WF9 sought help for heroin problems; 75 per cent. of them were unemployed.
It is well known that a rising tide of criminality is associated with drug taking in all areas. I suppose that my area of Hemsworth reflects the general position. A recent Government study of 1,000 drug users demonstrated that in a three-month period those 1,000 people were responsible for 70,000 criminal offences—a staggering figure. Heroin addiction costs some £200 a week, and the crime that is committed to pay for that dependency costs some £1.5 billion.
A small-time drug pusher in a town in my area told me what happened when the drug mafia arrived in the town. He said that a quartermaster was put into the town to act as a drugs wholesaler and then a retail operation was set


up on each estate and in every street in the town, which has a population of some 8,000 people. A separate arm of the same organisation was then formed to collect the money owed by the unfortunate people who had developed a drug dependency. A further arm consisted of two individuals whom I can only describe as pathological murderers. They were two brothers who came into the town as enforcers. Thus there was a quartermaster, a distribution network, a collection network and two payment enforcers. Violence was used regularly by the two enforcers, and I am aware of at least three deaths that were the direct result of activities by drug gangs in my area in the three years in which I have represented the constituency.
This is a pestilential problem for our community. It requires both national and local action, and I am pleased that the Government have announced a strategy. I know Keith Hellawell very well. He was the chief constable in West Yorkshire, which I have represented for many years and where I have lived all my life. I have no doubt that he will bring energy, passion, determination and intelligence to the business of tackling this problem.
Three initiatives would help to tackle the problem. First and foremost, the villages and towns that I and many other hon. Members represent need jobs, economic development and regeneration. The Government are modernising the country and bringing about economic regeneration, but it is not inevitable that that will touch the villages and towns in the coalfield areas. We need Government action to do that and I commend to the House, as many others have previously, the coalfield task force report and the new deal.
Regeneration and jobs alone will not necessarily resolve the problem. When a local business person saw four young lads selling drugs at the corner of the street, he felt ashamed that people in his village were selling drugs so he went up to them and said, "Look lads, I'll give you all jobs." They said, "Well, how much will you pay us then?" He said that he would start them on £100 a week and see whether, after three months, they were any good. They replied that they would not take a job for £100 a week because they could make that in a night selling drugs. Therefore, regeneration plays an important role in giving hope to communities where there has been only despair—but it is not enough. People need real jobs that give them careers, prospects and self-respect.
Secondly, drug action teams have been established and are doing a good job, especially the Wakefield drug action team. Some teams are also piloting drug courts, which have also been successful. Magistrates and many other people involved in the pilot are working very hard, with remedial programmes, to help those who have been convicted of using or selling drugs. Although I do not have time to talk in great detail about the drug courts' work, other hon. Members may want to see how the pilot is working in Wakefield. I commend the pilot, which I think will provide a model for the rest of the United Kingdom.
The Wakefield drug action team is also building partnerships with educators and others. That work, too, is commendable.
Thirdly, our drug action team has ensured that it has a community base and is known within the villages by working with local agencies and using local volunteers and professionals. We have to win drug users' confidence if we are to get them over the rehabilitation threshold.
I should like to press Ministers on one problem: the short-term funding of many of the agencies involved. If we are to resolve the drugs problem, the agencies working to achieve that aim, and those who work in the agencies, will have to know that they have more than two or three years to do so.
Finally—I speak not only for the communities I represent, but personally—it is time to get tough with drug pushers. Frequently, we know who is pushing drugs, precisely where they live, which drugs they are pushing, and their turnover. However, it seems to take police an unbelievably long time to compile evidence before bringing charges. Although police deny it, I suspect that a decision has been taken to tolerate a certain level of activity. If that is true, it is unacceptable. If it is not true, I simply press Ministers to ensure that police explain to local, elected representatives and community leaders why it is taking so long to take action against identified individuals whose addresses we know.
In many cases, drug dealers operate out of privately rented houses owned by absentee landlords. Although many private landlords are exemplary in managing their property, in many cases, especially in coalfield areas, absentee private landlords have absolutely no interest in what happens in the houses that they let. Such tenancies often involve disgraceful behaviour and drug pushing, and local authorities need stronger powers to address that specific issue.
I commend the Government's action and developing strategy on drugs. However, stronger powers are needed to address the issue. The police in particular have to take an increasingly higher profile in dealing with the problem by making high-profile arrests and—with the media's help—publicising subsequent custodial sentences.

Mr. Howard Flight: Some time ago, I was fortunate enough to visit Baalbek, where the temple of Bacchus was decorated with grapes and poppy seeds. Drugs have been with us for a very long time. We grew up reading of Sherlock Holmes, for example, who smoked his pipe of cocaine when he wanted to clear his brain after solving a crime.
In the past 100 years attitudes have changed. Previously, laudanum and opium-based drugs, and cocaine smoking, were not thought to be a terrific threat to society, or a social problem to be banned. Britain and the rest of Europe engaged in the opium trade, selling opium to China. At that time, such trade was thought to be very much like selling American tobacco to Europe.
Why has there been the change, and what is its context? My first point concerns China. Shanghai became a rotten, drug-soaked society because of excessive opium smoking. That threatened not just social destruction, but economic destruction. At the bottom of the debate is the fear that the west is in danger of going the same way, and being destroyed by drugs.
I suspect that that fear is greatly exaggerated. The figures show that 50 per cent. of 25-year-olds have tried drugs, and that 25 per cent. of 16 to 24-year-olds have tried drugs once in the past year. The number of addicts in this country is still not huge.
Having had four children—the youngest of whom is 11—I confess that I am frightened by drugs because I see what happens in schools. No matter the type of school, drugs are pushed. It is remarkable if a child can go through school without experimenting with drugs at some stage. Thirty or 40 years ago, it was not like that. Naively, I should say that I have been offered a joint only once in my life—in America, 20 years ago.
It is completely different for children today. Drugs are pushed at them all the time. Bluntly, those with stronger characters either do not indulge or, if they do, do not continue because the price is too high. It is the more vulnerable members of society who end up becoming drug addicts, irrespective of whether they come from poorer or richer backgrounds. The problem crosses society.
There is also the major problem of crime, referred to by the hon. Member for Hemsworth (Mr. Trickett). The unfortunate equation is that criminality keeps the price of drugs high—which must reduce demand—but, at the same time, it causes drug-related crime, because those who become addicts clearly take to crime because they have not got the money to pay for drugs.
The last Conservative Government programme was entitled "Tackling Drugs Together"; the new Government have merely added to that by calling their programme "Tackling Drugs to Build a Better Britain". Effectively, continuing Government programmes have not been successful in reducing the numbers of people who try drugs, as the numbers keep going up and up. The issue is how successful the programmes are in bailing out people who have become addicts.
The key new initiatives are the emphasis on prevention and on trying to persuade young people aged 15 to 16 not to take drugs. More particularly, there is support for co-operation between the police, local authorities, Customs and Excise and the probation service in the drugs action team initiative.
With regard to the former, I share the views expressed by other hon. Members that unless they are very clever, education programmes designed to put children off have the reverse effect—children naturally want to do outrageous things and to revolt against society to show their bravado. Children should be educated so that they know what to do if they have a real problem. I doubt that we will be successful in trying to persuade young people not to have a go if that is what they want to do.
I am concerned about the success of some of the more interesting and constructive programmes dealing with the problem at the coal face. Funds have been cut by about £1 million in London in the past year and there are rows about expenditure between the police and local authorities.
A marvellous man in my constituency has set up a charity called the Sussex Association for the Rehabilitation of Offenders. When the police apprehend people who are on drugs, it initiates on-the-spot treatment, catching people at their most vulnerable and getting them into programmes to try to help them to kick their habit. SARO has achieved considerable respect right along the south coast and it is expanding like fury all over the place. It is currently financed wholly charitably by the individual behind it.
I have been in non-party political correspondence with the Home Office appealing for a meeting to try to break the logjam of both the police and the local authority

saying that they will not give any more money. There is supposed to be co-operation on drug action teams and similar initiatives but there seems to be a stalemate and the Home Office is not helping. I would warmly welcome anything that the Minister can say on SARO and on the general problem.
We need to reduce both supply and demand. It occurs to me, perhaps improperly, that if the west collectively feels that it is entirely justifiable to intervene in the Balkans to stop that which is vicious and destructive of society, there may be an analogy with those parts of the world that are wantonly causing human misery by the production and commercial selling of drugs. I am not advocating military intervention, but is not there some argument for a much more aggressive approach towards tackling the supply on the ground? Nothing of any impact has been done so far.
China, remarkably, stamped out the Shanghai problem by the most appallingly brutal punishments. After the communists came to power, anyone having anything to do with drugs was immediately executed. I am in no way suggesting that we should follow that policy, but if we are serious about trying to limit supply, it is not enough merely to have the poor old police toiling away with Customs and Excise and scratching the surface, beneath which there is a £40 billion a year trade that is not being restricted at source in any way. There is no effective deterrent.
I am sceptical about the impact on demand of educational programmes. The best that one can do is to endeavour to bring up one's children to be as sensible, streetwise and balanced as possible. I have been very fortunate, because my wife gave up her career to bring up our four children and I have always worked and not had the hours to do it. Latch-key kids with only one parent around are much more vulnerable.
Candidly, people in traditional, two-parent families do not let their children go to rave parties where they take Ecstasy and die by mistake because it was toxic. I believe that the central Conservative philosophy of encouraging traditional, disciplined two-parent families will do more than anything else to prevent children from getting into drugs.
I listened with enormous sympathy to the hon. Members for Bolton, South-East (Dr. Iddon) and for Newport, West (Mr. Flynn); that is why I asked them some questions. Clearly there is a prohibition argument that, in terms of reducing both the criminal element and the trendy element in drug taking, drugs should be decriminalised, and then many of the problems would go away.
Prohibition in the United States certainly did not stop people from consuming whisky or other spirits, and it led to the sale of poisonous spirits, just as criminalisation here clearly leads to the sale of toxic drugs. However, if we accept that argument we must accept that a major reduction in the price of all forms of drugs must, in the round, lead to an increase in demand. It would be extraordinary if drugs were unlike any other commercial goods in that way. I asked my hon. Friend the Member for West Dorset (Mr. Letwin) whether it was possible that there would be a reverse demand curve, or that the elasticity of demand would be so peculiar—but it must be exceedingly unlikely.
If we, like Holland and Switzerland, moved towards decriminalisation, we would have to accept that although some problems would be solved, drugs in all forms would become more like drink and cigarettes, and overall consumption would rise. As my hon. Friend the Member for West Dorset pointed out, the debate about whether that would be a good thing or a bad thing is another issue.
It is difficult to justify the argument that decriminalisation would reduce consumption. It would reduce a lot of the problems, and would make many of them easier to deal with, because drug use would be above board legally, rather than hidden away as a criminal activity. None the less, overall consumption would rise.
If we do not want to go down that route, and drugs become a bigger and bigger problem, we shall have to think about the alternative approach, and ask how we can effectively reduce supply—that will mean tackling supply from the countries where drugs are grown—and introduce penalties that work against drug pushing, especially in schools.
At present our policy is to sit on the issue, keep demand down through relatively high prices, and tackle the problems that result, such as people who become addicted—although we could do a lot more in that respect. Broadly, we try to contain the situation.
I am not convinced that that is a workable long-term balance, and in future we may be forced to go one way or the other. Either we may have to accept decriminalisation, and the idea that we are dealing with something analogous to cigarettes and tobacco, or, if we are concerned that, like Shanghai, our society is being rotted by drugs, we will have to be a lot harsher in our penalties and our intervention policies aimed at reducing supply.

Mr. Michael Clapham: I am pleased to be called to make a contribution to this important debate, and I shall focus on my local community, Barnsley. I think that the Government's approach—the national plan—will work, and I was glad to hear the hon. Member for Arundel and South Downs (Mr. Flight) express what I took to be support for it.
The national statistics make frightening reading, but I shall not go through them because hon. Members can, if they wish, pick them up in the anti-drugs co-ordinator's first annual report on the national plan. People are now younger and younger when they first experiment with drugs and that causes us a great deal of concern. The evidence shows that the main drug is probably cannabis, but I have some statistics from Barnsley that will shock the House. In my constituency, heroin is the main drug and its use is widespread.
The Government's programme, "Tackling Drugs to Build a Better Britain", outlines four areas on which we should concentrate—first, work to help young people to resist drugs; secondly, protecting communities; thirdly, ensuring that treatment is available for those who want it; and finally, stifling the supply of drugs. I mention those four planks, because I shall show how they are being implemented locally. The remit of the local approach,

especially after the Crime and Disorder Act 1998 and the fact that local authorities are working with the police, is now much wider than that of the drug action teams, although they are still very important and at the forefront of the current work.
In Barnsley, we have had a crime prevention partnership for five years which has been reconstituted under the crime prevention legislation. I have chaired the policy board for some five years, so I see what is happening locally. The new structure—the safer community partnership—provides an overarching mechanism that links together coherently all the work that is being done within the local authority.
Drug taking in Barnsley has increased. Despite all the work that the local authority has done on regeneration, there is still a long way to go. The 1997 household needs survey showed that the average income on council estates in Barnsley is between £5,000 and £6,000. The average income across the borough is £11,000, and that compares with an average income in Yorkshire and Humberside of £18,300. Those figures illustrate the depressed state of the local economy, which has put enormous strains on the local social structure.
It is estimated that 30 per cent. of the population in Barnsley have a disability or a disabling disease. Some 17,775 people receive incapacity benefit and 34 per cent. of children come from households in receipt of income support or family credit. Those statistics are evidence of the strains caused by the running down of the local economy, which happened quickly over four years.
Heroin arrived in Barnsley in 1994; until then its use was little recorded there. Now, the drugs action team estimates that between 3,000 and 5,000 people in the area regularly use heroin. Figures in the report by the anti-drugs co-ordinator show that a heroin user needs between £10,000 and £20,000 to feed his habit. At the lower end of those figures, that means that the cost to the local community of crimes committed to meet that habit is between £30 million to £60 million, and at the top, between £50 million and £100 million. We estimate that 80 per cent. of local crime is carried out by people who need to thieve to feed their habit. So the impact locally is enormous.
My wife is a social worker who deals with child abuse, and I regularly see the way drug use and the drug culture impacts on families, as I work in the community and meet the people on my estates. There has been a predictable increase in anti-social behaviour across the borough. People going to the estates to get drugs from dealers hang around and make life terribly miserable for those who live there.
People living on the estates in the village of Wardle Green in my constituency recently decided that enough was enough. They organised themselves, with help from local councillors and the police, and were thus able to get on top of the problem. The local authority had to evict a person, but two other bully-boys followed him and that success has led to every other house on the estate joining the neighbourhood watch system.
Although the drug action team is at the forefront of the effort in Barnsley, the Barn project deals with young people under 18 who seek help. Statistics show that, in the period between 1 October 1998 to 31 March 1999, the project has helped 81 young people. Of those, 46 per cent.


were on heroin, 18 per cent. used cannabis, and 16 per cent. had problems with alcohol. Again, that shows that heroin is the main drug used in Barnsley.
The women and drugs project in Barnsley is one of only two such projects in the country. It helps women with a drug misuse problem, or whose partners have such a problem. The services that it provides include counselling, a drop-in centre, a well woman clinic and beauty therapy. There is also an antenatal clinic, which is most important. It is staffed by midwives from the obstetric liaison group, who also offer a helpline for pregnant drug users.
In addition, the substance misuse team is staffed by nurses with psychiatric training, while personnel from the Barn project and other schemes offer extra help. Barnsley also has a patient detoxification unit at Kendray hospital. The unit has been working well: until recently, the waiting time for treatment was only one month. However, it is run on bare minimum funding, and I understand that two staff have left recently. The result is that the detoxification centre has had to cut the service that it provides. I hope that my hon. Friend the Under-Secretary will see what he can do to provide the centre with a little more finance to ensure that it can continue its work.
Finally, there is the Barnsley arrest referral project. It was set up in February, and Soya, the national charity that operates the scheme along with Barn and the National Association for the Care and Resettlement of Offenders, says that it is working well. In six months or a year, statistics will prove whether that is so.
One more project deserves a mention. The communities that care project, funded by the Joseph Rowntree Trust, centres on young people, seeking to identify risk factors in the community and to neutralise them. We have high hopes for the project. Oxford and Sheffield universities are doing much of the analysis, and we hope to implement the results of the project in communities other than Barnsley.
In addition to our general aim to tackle drugs to build a better Britain, we must give further assistance. As well as creating policy, we need to create jobs. The new deal is working well in Barnsley, with 675 jobs created for young people. However, there is a long way to go. We need jobs and industry, and I hope that the regional development agencies will be able to focus on local needs.
We need greater equality and inclusion. Barnsley is one of the United Kingdom's poorest boroughs, and positive action is needed to redress our disadvantage. Finally, we need greater redistribution of wealth into the area. Barnsley's local authority, health authority, social services department and local education authority do not have all the funds we need to regenerate and renew the social structure; nor does South Yorkshire police. Without extra resources, we shall not get on top of the problem. Substantial new money is needed. I hope that the Minister will look into whether resources can be made available so that our treatment centre can work effectively.

Mr. Brian White: I am glad that the hon. Member for Arundel and South Downs (Mr. Flight) mentioned the history of drugs. It is often forgotten that most of the British empire was founded on drug pushing. We do not tend to remember that part of our history. We need also to deal with the inconsistency

with which decisions have been made. It is difficult to talk about drugs rationally when debate is often emotive, so I appreciated what the hon. Gentleman said.
A constituent of mine has written to me over several months about her daughter's problems. At the end of one typewritten letter, she added, in handwriting:
I wish you could do something.
The impact of drugs on families tends to be forgotten, so I want to discuss the relationship families and friends have with the agencies. My constituent wrote that her daughter arrived at her home one night, begging for money, sweating and shaking. Her house had no electricity, and was boarded up after the front door had been smashed in. My constituent wrote:
I have the sure knowledge that if I give her this money I am stopping somebody being broken into".
She said that she would stop some shop being robbed. She knew that if she gave the money, the drugs that her daughter would purchase could kill her. What sort of choice is that? That point is critical.
We have talked about drugs education this morning. A former addict said that there are three phases to drug taking. The first is drugs for pleasure; the second is drugs mainly for pleasure, but with some pain; and the third is drugs with only pain. That describes part of the problem. There are all the scare stories that drugs are harmful, but the evidence that people have when they first take them is that they are pleasurable. I do not smoke, but I have been a passive smoker all my life—my parents smoked, my wife smokes and my kids smoke, so I have no chance. When people start to smoke they say that they get pleasure from it. Only later, as the hon. Member for Chesham and Amersham (Mrs. Gillan) described, do the pain and the problems of addiction start. We must recognise that fact.
Also, we must recognise that many drug users do not cause crime. They do not rob, but feed their habit with money that they earn. They have responsible jobs and carry on a normal life. They do not cause problems for the criminal justice system. However, for many other people, drugs have caused their problems with the system. It is important to differentiate.
We must also consider the way in which the various agencies react. A constituent of mine was responsible for about 1,000 car thefts. When the police eventually caught him, they gave him a choice of going to jail and serving a two-month sentence, or going to a detoxification unit in prison for a longer time and coming out drug-free. He chose the latter, but because he was in prison longer, he exceeded the limit for the number of days that he could leave his council house and so he lost it. What was the point of him going through that extra process voluntarily to be beaten by the system? One of the key problems that we must tackle is how other agencies, when taking individual decisions, relate to people who are trying to come off addiction.
Another problem with those who are coming off an addiction is that of what are called nomadic addicts—people who attach themselves to addicts and make their lives miserable. They are like limpets—they attach themselves and drag them down. My constituent writes:
The other problem is her friends, they do not want her to have any treatment, mostly through jealousy".
That is a key problem, which we must recognise.
Many of the comments that were made about drug action teams are true and I will not repeat them for the sake of brevity. I must point out to my hon. Friends


the Members for Barnsley, West and Penistone (Mr. Clapham) and for Hemsworth (Mr. Trickett) that I represent a constituency where there are jobs—more than 5,000 were created last year—but we still have a drugs problem. Jobs are not enough. They are important and I am not saying, "Don't create jobs", but other measures have to be taken to deal with the drugs problem.
I mentioned a constituent who has been writing to me. She is a very articulate lady and she has been trying to get help from the various agencies, but because her daughter is an adult, they always say, "She is her own person. We can't help you." One counsellor told her, "I'll counsel your daughter, but you will not be in the room." That is a critical problem. The attitude of agencies has to change so that friends or relatives who are trying to help people beat addiction are given support, and so that artificial barriers are not placed in the way. Most people know that when it gets to that level, drugs cause real problems for families. Addiction and support agencies also need to be there for friends and families.
The efforts of the drugs tsar, the drug action teams and the other issues that we have heard about are all fine, but a culture change is needed in other organisations. Councils, health and social security also play a part. It is not simply a matter of drug action teams, individual counselling agencies or voluntary groups dealing with the problem on their own.

Mr. Tony McNulty: In many ways, much of the debate today has been mature, reflective and grown-up which, given the usual debate on drugs, certainly in the British media, is rare. All those who have contributed should be congratulated on that.
There are several different thematic ways in which to address the problem of drugs. The first is education, which hon. Members have pooh-poohed rather too much today. There is a serious role for drugs education; it is not a panacea, as has been suggested. The second is containment, with all its incumbent difficulties. The third is the possibly foolish goal of eradication, which is unlikely—not least for tobacco addicts like me; I should have declared that interest at the start of my speech. We might eradicate some drugs, but certainly not all of them. The fourth is treatment. Much has been said about that, but more needs to be said about the substance of treatment, instead of what happens. The fifth is prevention, which is partly included in education. Finally, there is law enforcement.
I commend the exceptionally good speech made by my hon. Friend the Member for Wellingborough (Mr. Stinchcombe) about the role of drugs inside prisons. From what he said, and from what we already know, it seems that if law enforcement works as a containment by putting the perpetrators of the drug trade behind bars, all we have done is to shift the marketplace. All that has happened is that people in custody, who were previously drug-free, are now queueing up in that marketplace.
As my hon. Friend the Member for Milton Keynes, North-East (Mr. White) said, it is crucial that all institutions, agencies and sectors of society should work together. As he pointed out, the problem is not confined to the barren, windswept, poverty-stricken estates that

surround northern cities, or which exist in many parts of London. Drugs are not confined to deprived or working-class areas; they are found throughout society—as various marquesses could tell us, according to the newspaper accounts.
I should like to be able to say that, in an upper-working-class and middle-class constituency such as Harrow, East, we do not have a problem. We do. It might be a relatively small and more containable problem compared with those in other areas, but it exists and—like the problem everywhere else—it is growing. Furthermore, like everywhere else, there is a palpable shift from the use of what are mistakenly called soft drugs to the use of harder drugs. In London, the problem is not necessarily the leap from cannabis to heroin, but the more insidious leap to crack cocaine and cocaine in general. We are not talking about this in the fashionable, trendy, middle-class sense, in which a person is not someone at a party and part of the in-crowd unless a lump of white powder is hanging from his nose. Crack cocaine now causes as much difficulty in London as heroin.
It is estimated that three quarters of all drugs coming into this country touch London. Many pass on to other parts of the country, but London is the initial beacon for drug trafficking. In that context, what can we do? I will touch briefly on the points made by other hon. Members about what I understood to be community capacity building—trying to sort out all the elements that would ensure that drugs are not an alternative. That is a lovely, flowery phrase, but it does mean something. It means giving communities the capacity to grow and enrich their local civic culture in many ways, including economic development. That will help.
At the other end of the scale, all Governments—this is not a partisan point—have at least attempted to use international development measures to try to wean some countries off their mono-crop cultures of coca, cannabis or the heroin poppy. I hate the word globalisation; it is flawed intellectually and in other ways. However, drugs are a global problem, and must be tackled globally. It is not enough to say that some little canton in Switzerland has sorted out the problem, or that Holland has sorted it out, and that prohibition is the difficulty. That is nonsense. I say that with the greatest respect to my hon. Friends the Members for Newport, West (Mr. Flynn), who is no longer in the Chamber, and for Bolton, South-East (Dr. Iddon).
By removing prohibition, we only shift the scale and focus of the problems; we do not get rid of the problems altogether. The rudimentary law of economics dictates that somehow or other, much of the illicit trade—the pyramids referred to by my hon. Friend the Member for Newport, West—will remain. Drug barons up and down the land are not waiting desperately for the legitimation of a VAT registration number.
I am not trying to attack my hon. Friends the Members for Bolton, South-East and for Newport, West—drugs are a worthy subject of debate and dialogue, and I do not like the notion that that can take place only within extremely narrow confines. I fundamentally disagree with my hon. Friends, but I value their contributions. Even though they are completely and utterly wrong, if prohibition was working, we would not have to consider the alternatives to prohibition that they have suggested. We have to ask why prohibition is not working.
I am happy that the Government's strategy on drugs is based on prohibition, but many other elements are needed. We have to work in prisons, and work to achieve economic regeneration and development. I am happy, too, that today's debate has not been partisan, because if there is one subject among all those that we discuss that should not have party politics dragged into it, it is drugs. The drugs problem affects all parts of our society and all constituencies.
I dearly wish that the media took a grown-up view of drugs, not only in their reporting of drugs issues, but in terms of wider celebrity issues. Perhaps I am a harsh man, but I cannot understand why anyone should entertain the views of a man like Will Self and treat him like a serious journalist after the revelation that he had snorted heroin in the previous Prime Minister's aeroplane. Why should anyone take the man seriously? Why take a man like Robbie Fowler seriously, when he thinks that it is hilarious to imitate snorting cocaine on a football pitch? Why draw attention to pop stars who say that taking drugs is like having a cup of tea?
Because of their celebrity, those people have serious responsibilities, but the days when celebrities took those responsibilities seriously seems to be long past. Those who treat drugs as a fashion accessory are to be deprecated and dismissed as charlatans. The next time someone on television treats Will Self like a serious commentator, I shall write to that person and I shall encourage others to do likewise. If that is harsh, so be it.
The issue is not that all drugs equal crime. The issue is principally one of crime and socio-economic conditions rather than of health. By God, the health difficulties follow, but drugs are not primarily a health problem. Nor are we engaged in an elaborate game of cops and robbers. There are people who occupy professional positions in offices who go home and stick something up their nose or inject it in their arm. We have to see the problem in the wider context.
Ultimately, we have to address drugs as a cultural phenomenon and we have to tackle the problem through every single aspect of Government policy, rather than confining it to a single-issue ghetto. Much of what the Labour Government have done and the previous Conservative Government did makes progress in the right direction, but to believe that we are anywhere near to solving the problem is a fundamental error. I commend Governments for what they have done so far, but we have a long, long way to go before we solve a problem that is rooted in the culture and ethics of our society.

Mrs. Eleanor Laing: It is a pleasure to reply to what has been a truly non-partisan debate, as the hon. Member for Harrow, East (Mr. McNulty) has just said. I think that is the first time that I have agreed with the hon. Gentleman, but it is a pleasure to do so on this occasion—he should not be concerned about that.
The underlying theme of today's debate—I am glad that we have had a reasonable amount of time in which to discuss this important issue in some depth—is that we are all concerned about drug misuse and we all want to eradicate drug abuse. Of that there is no doubt. I am certain that the small number of hon. Members present in the Chamber does not reflect the level of concern among hon. Members on both sides of the House about that issue.

It simply happens to be a busy Friday. I can understand why the Minister, some of my hon. Friends and some hon. Members have had to leave before the end of the debate.
I have travelled around the country in recent months, and I found that, at almost every public meeting, when people were asked about their main concerns and what they would like the Government to address, the problem of drug abuse came very near the top of the list. That has certainly drawn my attention to the fact—I find myself agreeing with the hon. Member for Harrow, East twice in five minutes—that the drug problem affects every part of the country. It is not an inner-city problem or a problem peculiar to the north, the south or anywhere else. Drug misuse affects the whole of our country, and indeed the whole of Europe and the world. Therefore, it is good that we have debated the issue sincerely today and that the different points of view expressed have made it a constructive debate.
We have almost reached a consensus, first, that we must tackle both supply and demand; and, secondly, that the illegality of drugs is a deterrent to drug taking. I know that some hon. Members disagree with the latter point. We must consider prevention and cure and supply and demand. The drug problem is one of the most difficult to combat. It has arisen partly because of fashion and peer pressure and partly because of the recklessness of youth.
We all know that young people must rebel—it is part of their make-up—and, in some cases, that rebellion assumes the form of drug taking. People rebel in many different ways. Some rebel only when they are young and then settle down, and some continue to rebel for ever. Whatever form rebellion takes, the wish to be seen as different and to go against the instructions of others is part of being young. Everyone must go through that stage: we cannot ignore it. Somehow or other, Government policies must go with that trend and use it.
I welcome the Minister's commitment at the beginning of the debate not to legalise any drugs and to keep his policies under review. He said that the Government would watch carefully what is working and what is not; that they would not stick doggedly to previous statements, but would be willing to change policy if it appeared that other measures would work better.
I congratulate my hon. Friend the Member for Congleton (Mrs. Winterton) on her thoughtful and far-reaching introduction to this debate. She covered so many serious matters in such depth and demonstrated such knowledge of her subject that I will not touch on those points again. I am sure that the whole House welcomed her contribution as constructive and not merely critical of the Minister's opening remarks.
The hon. Member for Erewash (Liz Blackman) raised practical points, including the idea that we should encourage police involvement in DARE programmes in schools. I wonder what the Under-Secretary will say to that when he replies to the debate.
My hon. Friend the Member for Beckenham (Mrs. Lait) made a constructive, thoughtful contribution. She apologised for having to leave before the end of the debate. I am sure that the House will agree that she is to be admired for her constant crusade against tobacco and alcohol smuggling. Many of the problems that we face in that respect are the same as those caused by drug smuggling.
My hon. Friend asked whether the Minister could confirm or deny the rumour that there are likely to be about 1,200 job losses in Customs and Excise over the next three years. I hope that the Minister will be able to respond to that point at a later date if he cannot do so today. I appreciate that it is a rumour, but if it is true, it is serious; and if it is untrue, it would be good if it could be squashed straight away.
I am sure that the Minister will not answer the questions by constantly referring to what the previous Government did. This is a matter on which there is considerable consensus. I am, perhaps, pre-empting the Minister, but this is 1999 and we must consider how we shall proceed. I am looking to the future, not the past. There is no doubt that the policies that the Government are following are built on those of the previous Government, some of which were successful, but nobody is pretending that anybody's policies have solved the problem.

Mr. Flynn: Which of the previous Government's policies were successful?

Mrs. Laing: We have had a whole morning of debate about that. Policies of education and of clamping down on drug dealers and confiscating their assets have been successful to an extent. I am certainly not saying that those policies have solved the problem. Nobody is arguing that. The Government are building on the successful policies of the previous Government and I am sure that when the Under-Secretary responds to the debate, he will tell us what will be the Government's future direction.
My hon. Friend the Member for Beckenham also referred to more training for GPs in treating drug addiction. Will the Under-Secretary respond to that point? I appreciate that he cannot answer for his colleagues in the Department of Health, but the Minister for the Cabinet Office said at the beginning of the debate that the strategy stretches across all Departments. I suppose that it is part of joined-up government. Although I sometimes deride that concept, I was pleased to hear the Minister say that this issue is to be one for joined-up government because it permeates all areas of life. Will the Under-Secretary say whether there will be any guidance to help GPs in treating drug addiction?
The hon. Member for Bolton, South-East (Dr. Iddon) greatly assisted the House with his knowledge and experience in chemistry. I acknowledge his important role as chairman of the all-party drugs misuse group. We all look forward to the findings of the inquiry being undertaken by the hon. Gentleman and his colleagues. I share his horror about the tragic case of the little boy in his constituency who was killed during a drugs raid involving his father. Such tragic cases bring the problem to life in a vivid, upsetting manner. I am sure that that only makes us all the more resolute to try to solve it.
However, the hon. Member for Bolton, South-East confused me by his argument. He said—and I agree—that young people needed role models. I also saw the point of his argument about clinical trials in order to discover the medicinal properties of cannabis. There can be no harm in trials; that is not to take the next step. He went on, however, to give an instance of teachers who had grown their own cannabis and then lost their jobs. He suggested

that that should not have happened, but surely teachers are important role models for the children whom they teach and, indeed, for other children. I prefer the role model part of his argument.
The hon. Member for Twickenham (Dr. Cable), who, sadly, is also not able to be present, was right to describe drug dealing as an international business. I welcomed the intervention of the Minister for the Cabinet Office to agree that decriminalising drugs in one country has a significant effect on other countries. The problem must be treated as an international one. I hope that the Minister and his colleagues will be taking opportunities to discuss such matters with their counterparts in Holland and other relevant countries.
The hon. Member for Wellingborough (Mr. Stinchcombe) made a most welcome speech on the problems in prisons. He opened all our eyes considerably, and I thank him for doing so. I am pleased that he agrees with my hon. Friend the Member for Congleton about the need for simpler, cheaper and much more frequent tests on prisoners. I hope that the Minister also agrees; we will be interested to hear what he has to say on that point.
My hon. Friend the Member for Chesham and Amersham (Mrs. Gillan) made a most lively and amusing speech. I certainly support her endorsement of the DARE project, which several hon. Members have mentioned. It will also be interesting to hear what the Minister says on that. I agree with my hon. Friend as much as one possibly can about the importance in matters such as this of early education. I am sure that we all sympathise with her agony of giving up cigarettes. Since she has not had a cigarette since March, we can almost see her halo. She is a very good example of persistence in getting rid of addiction, if I may call it that.
My hon. Friend made me realise that I am an example of someone who benefited from early education in these matters. When I was a very small child in the mid-1960s, Richard Dimbleby, the late, great broadcaster, made a documentary for television about the dangers of cigarettes and heavy tobacco smoking and its links with lung cancer. I do not remember the documentary at all—I was far too young—but I realise that it was the first time that the link between cigarettes and severe danger to health had been properly identified. Two weeks after Richard Dimbleby had made that documentary, he died of lung cancer. My father, who until that point had smoked 40 cigarettes a day, laid down his packet of cigarettes and never smoked another in his life.
I make that point because, as a result of such dramatic early education, neither my brother nor I—I do not hold us up as paragons of virtue—has ever smoked a cigarette. It is a pity that my hon. Friend the Member for Chesham and Amersham did not watch Richard Dimbleby.
The hon. Member for Newport, West (Mr. Flynn) made his usual very different contribution. He is right to be controversial and I admire his tenacity and consistency, but I disagree with his argument, he will not be surprised to hear. Most of my hon. Friends do likewise.
My hon. Friend the Member for West Dorset (Mr. Letwin) made his customary clever analysis of the basic question. Over the next few days I shall recommend to hon. Members who have not been here today that they read his speech. As usual, he cut through the arguments and set the issue out clearly: on what grounds can we as law makers legislate to prevent people from harming


themselves? I entirely agree with his enlightened argument and his conclusion that taking drugs is different from other activities to which it is compared, such as taking alcohol and tobacco, and that it should therefore be treated differently. The vast majority of hon. Members agree.
My hon. Friend the Member for Arundel and South Downs (Mr. Flight) talked about the importance of family involvement. He, too, hit the nail on the head when he said that decriminalisation would merely shift the problem. If we decriminalise drugs, for whatever reason, we shall still have to deal with the same problems of addiction and misuse, but we will not then have the same weapons to combat them.
I also commend the speeches of the hon. Members for Barnsley, West and Penistone (Mr. Clapham), for Hemsworth (Mr. Trickett) and for Milton Keynes, North-East (Mr. White). They all gave practical examples, which opened the eyes of many of us to the on-going problems of drug abuse.
As I said, I agreed with some of the points made by the hon. Member for Harrow, East. Another point on which I agree with him is that this problem occurs throughout the country and in every walk of life. One aspect of the problem that we must tackle is that of fashion, peer-group pressure and the recklessness of youth. That occurs in every walk of life. I am pleased that the hon. Gentleman agrees with my hon. Friend the Member for Arundel and South Downs that we shall simply change the focus of the problem if we legalise drugs.
We almost have a consensus in the House this afternoon. We all know what we want to do and to achieve. Although Conservative Members question the Government's policies critically but constructively, in general we support what they are trying to do. We shall not be able to assess the effectiveness of the United Kingdom anti-drugs co-ordinator until 2002, by which time we shall be able to see whether his appointment and the policies that he is following have made a difference. We all hope that he will make a difference and will succeed because we want to solve this problem.

The Parliamentary Under-Secretary of State for the Home Department (Mr. George Howarth): I welcome the hon. Member for Epping Forest (Mrs. Laing) to her first outing at the Dispatch Box. Her speech was consensual, which on this subject is entirely appropriate, and full of common sense. From my experience in the House, I know that even in this place common sense sometimes prevails.
My hon. Friend the Member for Harrow, East (Mr. McNulty) said that the problem was widespread and the hon. Member for Epping Forest confirmed that. It is true. Every housing estate, village, town and city in Britain has some sort of drugs problem. They may not all acknowledge it, but it exists. For the families and individuals involved, the personal tragedy is no less if they are Tara Palmer-Tompkinson or someone in my constituency, in Bolton or in Milton Keynes. The consequences of that personal tragedy are serious, regardless of a person's wealth or social standing. Although some people have more ready access than others to treatment, the personal tragedy is the same for everyone.
This has been a very good debate, ranging from references by the hon. Member for Beckenham (Mrs. Lait) and other hon. Members to the problem's international dimension, to accounts of the problem in local communities. The local dimension was described in particular detail by my hon. Friends the Members for Hemsworth (Mr. Trickett), for Barnsley, West and Penistone (Mr. Clapham) and for Milton Keynes, North-East (Mr. White).
The hon. Member for Congleton (Mrs. Winterton) and other hon. Members highlighted the well-established link between drugs and crime. Clearly, those who traffic in drugs are committing a crime, but the fact is that most of those who use hard drugs finance it by various criminal activities. It is no good pretending that that link does not exist, because all the evidence shows that it does.
Other hon. Members raised important points about drug prevention and drug treatment. My hon. Friend the Member for Erewash (Liz Blackman) and the hon. Members for Chesham and Amersham (Mrs. Gillan) and for Congleton commented on the DARE programme, which I shall deal with in more detail later in my speech.
Many other points were made in the debate, and I may not be able to reply to all of them—not because of any unwillingness, or inability, to do so, but because we have limited time. However, I shall read today's Hansard and write to hon. Members whose questions I am unable to answer today, to try to give them some enlightenment on the issues that they raised.
Some hon. Members—including, perennially, my hon. Friend the Member for Newport, West (Mr. Flynn)—raised the issue of legalisation and/or decriminalisation. I should like to make it abundantly clear that the Government have no intention at all of decriminalising or legalising any of the substances that are currently illegal in the United Kingdom. I also believe, very sincerely, that it would be wrong to do so. Legalisation or decriminalisation would send the signal, particularly to young people, that it is all right to take drugs. But it is not all right.
My hon. Friends the Members for Milton Keynes, North-East and for Harrow, East mentioned, as did the hon. Member for Congleton, albeit indirectly, the problem of a drug culture, both in the United Kingdom and elsewhere. I believe that, ultimately, efforts to find celebrities from the sports or entertainment world to stand up and say, "Drugs are bad—I think you should stop taking them", will be self-defeating. I am not saying that those people should not send that message, but we should not invest too much hope in that approach solving our problems. Very often, people who take such a stand discover that, because of the nature of our popular press, an aspect of their previous life is dragged out, totally undermining the message that they try to send. The sad truth is that, when such approaches have been taken, they have had an effect completely opposite to that intended. I say that not to be clever or to try to make a debating point, but because it is a sad fact of life.
Several hon. Members mentioned drugs education, which I think is a more productive approach to addressing the issue. In the late 1990s, nearing the new century, how should we approach young people on the drugs issue? More importantly, how do we do so in a way that makes an impact on them? It is no good developing programmes that do not have an impact. We must use the available evidence to construct programmes that work.
The previous Government started a programme—which we have continued—through which we have evaluated the programmes of more than 60 different initiatives taken in local communities. We know from that what has been successful and what has not. I have visited one project involving Manchester city council and Manchester City football club, which focuses on young people training for sport. It uses the football club to make the distinction between a healthy life style—which does not involve drugs, tobacco or alcohol—and an unhealthy one that does not sit well with sport.
Other projects involve communities coming together, with professional help, to get powerful messages across to local young people that taking drugs damages their lives. There are many examples which must be independently evaluated to see what works, and we are doing just that.
The perennial argument made by my hon. Friend the Member for Newport, West, among others, concerns legalisation or decriminalisation. I shall say a brief word about medical use. If any product can be developed that proves to be helpful to people in a medicinal sense and can be clinically trialled and shown to work, the Government—as my right hon. Friend the Secretary of State for Health and others have made clear—will not stand in the way of that product being marketed and licensed in the usual way.
It would be irresponsible to base policy on the medical use of cannabis purely on anecdotal evidence. The decision must be based on science. As and when science proves that it is medically beneficial in some cases, that will be the appropriate time to take such action. To do anything else, or to say that cannabis should be dealt with differently from any other drug that may or may not have medicinal properties, would be wrong.
My hon. Friend the Member for Newport, West and others have said that decriminalising or legalising cannabis would have some impact on consumption, and would certainly have an effect on criminality. The simple truth is that in this country somewhere between 10 million and 11 million people smoke. As we all are in confessional mood today, I can say that I am one of those people. I wish that I could give it up, as the hon. Member for Chesham and Amersham has done. There are something like 20 million to 30 million people in this country who regularly drink alcohol. Appropriately, I am glad to see the Minister for Public Health on the Front Bench, because she has important things to say about the damage that tobacco and alcohol abuse can do to people's lives.
There are currently between 1.5 million and 3 million people in this country who have used or regularly use cannabis. One simple conclusion drawn by the hon. Member for Twickenham (Dr. Cable) and by the hon. Member for West Dorset (Mr. Letwin) is that if cannabis were legalised, the number of people using it would creep up towards the 11 million who smoke. It could even creep up towards the 20 million or 30 million who drink alcohol. The companies that decided to produce and sell cannabis products for recreational use would market them aggressively.
We should not automatically assume that the black market would disappear. Many people have a big stake in the illegal market and they would probably continue by

undercutting the legal producers. The point made by the hon. Member for Beckenham about tobacco and alcohol smuggling simply underlines that point.
There is mounting evidence of the problems that cannabis can cause. The hon. Member for Congleton referred to some of them. The World Health Organisation published evidence last year showing that there are consequences to smoking or using cannabis. I am sorry that my hon. Friend the Member for Newport, West is not here to hear me saying that one of the things that I find mildly frustrating about him is that whenever he speaks he claims the status of a scientist to justify his arguments and then proceeds to base them on anecdotal evidence. I suspect that if he thought more deeply he might decide to look at some of the scientific evidence rather than listening solely to anecdotes.
The hon. Member for Chesham and Amersham spoke about crop substitution, which is an important initiative. My right hon. Friend the Deputy Prime Minister and I attended the United Nations Special Assembly last June, where the policy on that was agreed internationally. I am proud to say that we support three crop substitution projects: one worth £3 million in Pakistan; one worth £720,000 in Bolivia; and a third worth £2.5 million in Peru.
Those are fairly small sums but there are also projects run by the United Nations and others and significant work is being done in crop substitution. I hope that the hon. Lady will forgive me if I do not get into the details of the benefits of chrysanthemums but I will investigate the subject and write to her.
If I have been unfair to the hon. Member for Congleton she will correct me. She referred to drug treatment and testing orders and said that she thought that they had been a failure. We decided to pilot them in Liverpool, Gloucester and Croydon. To date—this is up-to-the-minute information—78 orders have been issued and 11 have been revoked. We wanted to pilot the programme to find out where the problems are. We are monitoring the programme, which is only halfway through.

Mrs. Ann Winterton: rose—

Mr. Howarth: I will not give way to the hon. Lady, because it is 28 minutes past. I do not think that the programme has been a failure.
My hon. Friend the Member for Wellingborough (Mr. Stinchcombe) made an interesting speech about drugs in prisons. Significant resources are going into the Prison Service over the next three years, matched by resources from the service itself. He asked about sniffer dogs. I am pleased to tell him that 70 new dogs are being trained and will be put to use by the end of the financial year.
There is a tremendous amount of anecdotal evidence that because of mandatory drug testing there has been a switch in prisons from cannabis to opiates. We commissioned two independent studies last year, neither of which found any evidence to support that. We are vigilant on the subject. I am proud to say that, as a result of the changes that we have made in the testing, the number of positive tests has reduced from 24.41 per cent. in 1996–97 to 18.5 per cent. in 1998–99 so far. That proves that we are driving down drug use in prisons.

It being half-past Two o'clock, the motion for the Adjournment of the House lapsed, without Question put.

ADJOURNMENT (SUMMER)

Motion made, and Question put forthwith, pursuant to Standing Order No. 25 (Periodic adjournments),

That this House, at its rising on Tuesday 27th July, do adjourn till Tuesday 19th October.—[Mrs. McGuire.]

Question agreed to.

BUSINESS OF THE HOUSE

Ordered,
That, at the sitting on Tuesday 27th July, the Speaker shall not adjourn the House until she shall have notified the Royal Assent to Acts agreed upon by both Houses.—[Mrs. McGuire.]

DEREGULATION COMMITTEE

Ordered,
That Mr. Oliver Letwin be discharged from the Deregulation Committee and Mrs. Teresa Gorman be added to the Committee.—[Mrs. McGuire.]

COMMITTEE OF PUBLIC ACCOUNTS

Ordered,
That Mr. Geoffrey Clifton-Brown be discharged from the Committee of Public Accounts and Mr. David Curry be added to the Committee.—[Mrs. McGuire.]

SELECT COMMITTEE ON PUBLIC ADMINISTRATION

Ordered,
That Mr. David Ruffley be discharged from the Select Committee on Public Administration and Mr. Nicholas Soames be added to the Committee.—[Mrs. McGuire.]

Cleft Lip and Palate Units

Motion made, and Question proposed, That this House do now adjourn.—[Mrs. McGuire.]

Mr. Robert Syms: I am raising an important subject today—the national health service cleft lip and palate units, which are now in a state of some turmoil because of the review undertaken by the clinical standards advisory group, which reported in February 1998. The process is now moving on. I especially welcome the presence this afternoon of my hon. Friends the Members for Runnymede and Weybridge (Mr. Hammond) and for Bournemouth, East (Mr. Atkinson), who may, I understand, make a brief contribution later.
The root of many of the difficulties is the proposed reduction in the number of centres from 57 to between eight and 15. Originally, the CSAG examined practice and outcomes elsewhere, especially in Scandinavia. In general, there is some logic to its proposals, but I have particular concerns about them as they relate to Poole.
The reduction in the number of centres is too great, and it looks as if the implementation of the proposals will be somewhat dogmatic. The date of 1 April 2000, by which everything is to be in place, is too soon. There is a feeling among my constituents and others that the consultations are not being taken as seriously by the NHS executive and the regional health authorities as they should be.
In the south-west, the proposal is to reduce the number of centres from five to one, based in Bristol, although that centre may work out of two sites, with Odstock in Salisbury as a second site. That is going too far, too fast.
I had a letter from the Minister of State, Department of Health, the hon. Member for Southampton, Itchen (Mr. Denham), in which he said:
No decisions have yet been made about the pattern of cleft lip and palate services in the south west, and the views and concerns of patients and their families are taken into consideration in the consultation process.
However, there is still a strong feeling that the proposals for the south-west executive have been set in a particularly firm framework, so that even if we make a case for the benefits of maintaining the unit in full, I am not sure whether that will fit in with the Government's framework. A local petition has so far been signed by 12,000 people and I have the support of many of my colleagues in the south-east Dorset conurbation.
The 1997 White Paper, under the heading, "A New Start", said:
The needs of patients will be put at the centre of the care process",
and said that the Government would
rebuild public confidence in the NHS as a Public Service, accountable to patients, open to the public and shaped by their views".
Under the heading "Keeping What Works", the White Paper also said:
If something is working effectively then it should not be discarded purely for the sake of it".
The key point is that Poole as a unit is working effectively, and should not be discarded. The Poole unit is different from other units in the Wessex region, because it uses a different technique pioneered by Professor


Delaire in Nantes, in France. It is a regenerative process in which the face is rebuilt so that the muscle can grow. A child whose face has been rebuilt in that way will need less surgical intervention in future. The process allows more natural growth, and has a good record. It is used widely in Germany, France, Canada and the United Kingdom. Poole has been so successful that it has taught many surgeons from Africa and Russia to use the method in their countries.
One of the problems with the present review is that because that method is only one of two methods, there is a risk that we may lose many of the centres that use it. Tony Markus, the surgeon who heads the Poole unit, is one of the foremost national experts in that method, and has published several papers in journals such as the British Journal of Oral and Maxillofacial Surgery. There is concern among patients that following the review, they may have to go abroad, to France or elsewhere, to get such treatment. That is causing a great deal of concern.
Another important point about the Poole unit is that it has conducted an audit and published its results, whereas other units have not published that essential information. It is therefore difficult to make comparisons using the available data, although the data from Europe permit some comparison to be made. The Freiberg analysis is of particular merit, as it covers both the plastic surgery method and the Professor Delaire method. Evidence from parallel studies over a number of years demonstrate that better results are achieved by the maxillofacial technique.
The cost of centralising a region's operations into one centre does not appear to have been analysed critically other than in the broad-brush terms. The maxillofacial treatment usually requires only between one and three operations, whereas plastic surgery requires many more. Moreover, the changes made by plastic surgery do not grow with the child, so fairly regular operations are needed to compensate for growth. Cost ought to be a factor, especially if the method shows signs of success.
If the proposals are implemented, the practical effect will be that parents in the south west and the Wessex region will not be able to choose to have their children treated by the maxillofacial method, which would not be available at Bristol or Odstock. Parent meetings of the Poole group have been informed by member parents who have suffered treatment at Bristol, Manchester and at other units in the midlands that under no circumstances would they allow their children to be treated by those plastic surgery units again.
There is a great deal of support, among parents and patients who have experienced the benefits of the Poole treatment, for maintaining the unit. There is supposed to be freedom of choice under the national health service charter, but the proposals, if adopted, will mean that maxillofacial treatment will survive only at units in the north of England, if they too are not axed by the end of the process.
Published evidence in the United States shows that the attitude of parents to family involvement in cleft palate techniques can be a significant help in such cases. I believe that the system used in Poole commands much public support. The support and co-operation of parents with children suffering from such problems are vital, and the method is tried and tested.
Given that no other unit apart from Poole has published audited accounts, and that such accounts from the continent indicate that better results are being obtained by the maxillofacial process, it appears that the proposal could cause standards here to fall significantly. The Dorset hospital trust and the local health authority support the maintenance of the internationally acclaimed unit at Poole. How can the regional authority or the Government seek to override that local support and international recognition?
The local parent support group has made the strongest representations to the regional authority to be permitted representation at the final meeting in Bristol. None of the three letters that it sent has been answered. The only response was to the regional representative of the Cleft Lip and Palate Association in Exeter, who has no knowledge of or connection with the Poole unit, nor any personal knowledge of the techniques used there, which have international support.
It has been intimated that the regional authority wants decisions to be made by July. What criteria will govern those decisions, and what has happened to the three months consultation period that was first suggested? How is the right of choice under the patients charter to be addressed?
Centralisation in Bristol would be bound to remove all local support for the system that is currently available, and poorer families who could not afford the travel and accommodation that the proposals would require would suffer especially severely. This form of treatment needs a multidiscipline approach and support from many people, such as speech therapists. There is a fear that some of that team approach will be lost if Poole relinquishes its ability to undertake surgical interventions.
The road system between Bristol and Poole has not been improved significantly since the second world war, and travel by rail usually means two changes and significant cost. That is a very real problem for my constituents. An earlier attempt to centralise services at Bristol involved the Bristol baby heart unit: that offers a poor precedent.
The problems of reorganisation in Poole are causing much public concern. The local newspaper has run a campaign against the plan, and most of the parents who have witnessed the benefits that the unit has given to their children want it to remain open so that it can provide a service to people all along the south coast.
I plead with the Government to listen to representations made to them. The technique pioneered by Professor Delaire, and used by Tony Markus in Poole, must not be lost at the end of the review. It makes sense to have choices of treatment so that we can judge which is best. Choice also offers a degree of diversity in the health service. It would be a great pity if we lost Delaire, ending up with just a plastic method. Many nations—Russia and Africa included—are getting on to our method, which is proving successful.
I shall be interested by what the Minister says. The demands of parents in Poole should be heard by the Government and the executive of South-West regional health authority.

Mr. David Atkinson: On my own behalf and that of my hon. Friend the Member for Bournemouth, West (Mr. Butterfill) may I congratulate


my hon. Friend the Member for Poole (Mr. Syms) on securing the debate? We support all that he has said. Like him, we have received expressions of concern from constituents who are absolutely devastated and extremely distressed by the clinical standards advisory group's proposal to close the Poole unit in favour of Bristol.
The proposal overlooks the fact that treatment for cleft lip and palate is not a one-off operation, but a continuous process requiring regular attendance and treatment, for more than 10 years in many cases. A 27-year-old constituent of mine tells me that he has had 23 operations. He enjoyed no quality of life during his youth and adolescence. After years of trial-and-error treatment, he is finally enjoying confidence for the first time in his life because of the care that he has received from the brilliant pioneering team at the Poole unit, led by Dr. Markus.
It is inconceivable that the Poole unit should be closed and that our constituents should be required to travel as far as Bristol—a four or five-hour round trip, plus waiting time and treatment time. The Minister would not wish such an imposition on her own constituents. I hope that she will ensure that it does not happen to ours.

The Minister for Public Health (Ms Tessa Jowell): I congratulate the hon. Member for Poole (Mr. Syms), who has been assiduous in raising the cleft lip and palate service at Poole. I also appreciated the speech made by the hon. Member for Bournemouth, East (Mr. Atkinson).
Across the country, we are embarking on a major service reorganisation for highly specialist services. We want all children to achieve the best possible outcome from their care. It is important that services are organised in a way that achieves that aim. That is as important for families in Poole and Dorset as it is for families in the rest of the country.
The hon. Member for Poole will understand that in commenting on the designation of specialist cleft centres, I must be careful not to prejudge issues. Where changes in the commissioning arrangements represent a significant alteration to a local service, local consultation will be needed. If the local community health council contests any change—no doubt it will properly represent the views of the local Cleft Lip and Palate Association groups—it will have to put forward a viable alternative plan. The Secretary of State would consider that plan alongside health authority submissions before making a final decision. This afternoon, I do not want to pre-empt that process in any way.
What I can say is that we are working closely with parents through the Cleft Lip and Palate Association. At national level Gareth Davies, the association's chief executive, is a key member of the cleft implementation group. He is clear about the aims, which are to ensure that the best care of children comes first. He appreciates that it is not possible for every district hospital to have a local cleft service, but in travelling to a major centre he, as a representative of parents, will expect all children to have access to high-quality treatment.
About one child in 700 is born with a cleft, which means about 1,000 new cases every year. It is the most common facial defect and no one really understands what causes a child to be born with a cleft. We do not believe that it has anything to do with what the mother does during pregnancy. Clefts are formed in the embryo at an early stage as a result

of a failure of the fusion process between the upper lip and primary palate. In some cases, there is a family link and it has been suggested that there might be an association with unknown environmental factors, but generally they just happen. Clefts are not usually diagnosed during pregnancy—it is unlikely that radiographers would always be able to make a confident diagnosis from an ultrasound scan—so most clefts are diagnosed in the delivery room. For the family, for which it is understandably a moment of shock and distress, care should begin from the moment that the baby is delivered and should continue throughout the child's growing years into adulthood.
Children with clefts and their families face many challenges. The hon. Member for Poole made it clear what a long journey many of those children face. A hospital admission is a traumatic event in anyone's life. Cleft children may need three or more operations. Cleft lips are usually repaired at six to 12 weeks, cleft palates at around six months. Other operations may be necessary to correct a misalignment of the jaw or to insert a bone graft in the upper jaw. Those are difficult and worrying times for parents. The quality of that surgery is therefore a major component of any care plan for a cleft child. It takes great skill and should be carried out by experts. It is not an operation that a surgeon can expect to carry out occasionally and still get good results.
For the reconstruction process to be effective, surgery must be part of a co-ordinated package of care provided by a whole host of health care professionals, working in multi-disciplinary teams. It is crucial that the care and treatment of clefts is properly co-ordinated to overcome the risks of facial disfigurements, dental problems, poor hearing and speech disorders, all of which can have an enormous impact on a child's healthy development. Standards at every stage must be the highest possible. Failure to provide proper speech therapy or dental care can be devastating and lead to a range of what are essentially avoidable problems.
There was concern for many years that the treatment of clefts was less good than it should be, with enormous variations in general treatment standards. I suggest that all of us who know children who have been born with that disfigurement can bear testimony to the high degree of variation in the quality and range of treatment.
Those standards were often below what was expected in other European countries so in July 1995, following representations from the Standing Dental Advisory Committee, the previous Government asked the clinical standards advisory group to review the delivery of services, paying particular attention to the comparative
effectiveness of care provided by high and low volume provider units, as measured in terms of clinical outcomes and other patient-centred measures.
The CSAG appointed a committee led by Professor John Murray and Dr. June Crown, supported by a team of experts, reflecting the range of services needed by cleft children and adults. The team included Tony Markus, the consultant maxillofacial surgeon in Poole, to whom the hon. Member for Poole paid tribute.
The CSAG reported in February 1998. What it discovered was disturbing; the recommendations were quite clear in finding that standards of care across the country were on average very poor. The CSAG found 75 surgeons carrying out primary cleft surgery in 57 centres in the UK. There was a general inability for centres to provide all the key members needed to form a multidisciplinary team.
Surgeons with a high volume of operations had better results than those with a low volume. That is clearly a crucial determinant of the quality of outcome for children. At 12 years of age, 20 per cent. of children had poor lip appearance and 42 per cent. had poor nasal appearance. All children who had unilateral cleft lip and palate surgery should ideally have received an alveolar bone graft before their 12th birthday, but 16 per cent. had not. For those who had, 58 per cent. of the grafts were unsuccessful. Speech was difficult to understand in 19 per cent. of 5-year-olds and in 4 per cent. of 12-year-olds. Twenty-seven per cent. of 5-year-olds and 31 per cent. of 12-year-olds had developed excessive nasal tone caused by inadequate closure of the palate. Only 67 per cent. of 5-year-olds and 53 per cent. of 12-year-olds had a completely successful outcome from secondary velopharyngeal surgery. Only one unit provided evidence of clinical audit over a 12-year period.
The CSAG took the view that that proliferation of centres and surgeons, and the absence of a complete multidisciplinary approach, had resulted in variable care, and relatively poor clinical outcomes for patients. As a result, the group recommended that there should be no more than 15 cleft centres for the whole of the UK; that each surgeon should treat between 40 and 50 cases a year; and that orthodontists and speech and language therapists should be similarly experienced.
Although the CSAG's research did not establish a direct link between volume and outcome, we took account of its very persuasive argument that clinical outcomes were most likely to be improved by concentrating scarce, highly specialist resources into fewer cleft centres. We recognised that poor clinical outcomes were likely to be due to the limited expertise in those centres treating small numbers of clefts. Better outcomes were most likely to be achieved where there were multidisciplinary teams of professionals, working well together.
We accepted that improvements in services can be addressed by reducing the number of existing services, but in doing so we emphasised that any reduction in the multiplicity of cleft centres should be driven by quality and effectiveness considerations. It is not simply a numbers game. We aim to drive up quality. Although we have accepted that treatment should be undertaken in fewer main centres, much of the follow-up care could be provided in more satellite centres, depending on local circumstances. Hopefully, that will reduce the inconvenience to children and their families referred to by the hon. Member for Poole, when they have to travel long distances, especially in rural localities. It will also enable parents to build a good relationship with their local cleft team.
The new arrangements for commissioning were set out in a Department of Health circular, which was issued in November last year. They included criteria for selecting specialised services, and a list of services, including cleft lip and palate services, for which some collective commissioning arrangements, below national level, might be necessary. Those arrangements will take effect in the 2000–01 commissioning round.
To support the NHS, we set up a cleft implementation group under the chairmanship of Dr. June Crown, who had been vice-chairman of the CSAG committee. The role of this group is to oversee the changes in service delivery

in accordance with the CSAG recommendations. It is supporting the NHS executive's regional offices in specifying the service standards expected of any designated cleft centre, and the arrangements for monitoring service agreements.

Mr. Syms: In addition to the setting of standards, it is important that there should be a degree of diversity so that we do not end up with only one form of treatment. The form of treatment that I mentioned should be included within the services.

Ms Jowell: I entirely accept that diversity should not be obstructed, but it is important that all treatments within the diverse range on offer should withstand scrutiny for clinical effectiveness. I would expect such scrutiny to apply to the Delaire method.
The CIG has produced a commissioning framework for cleft services. Any centre currently carrying out cleft surgery, including Poole, would need to demonstrate to its regional commissioning group that it can meet the criteria set out in that commissioning framework document. The framework ensures that there are clear pathways of care; that there is a full range of clinical and support skills available; that there is collaboration not competition, with all surgeons participating in national inter-centre audit; that children are treated in a proper paediatric environment; and that there are adequate facilities for parents who have to travel.
As I said, it would not be right to comment in detail on or to prejudge the proposals being considered in the south-west, as they may be referred to the Secretary of State for final decision. However, I understand that the region's preferred option is for a twin-site arrangement between Bristol and Salisbury. That would mean that one cleft team would work on two hospital sites, under one clinical director. All staff would be expected to work on both sites.
The region is currently mapping out the detail of the hub and spoke arrangements. That work is being led by teams from Bristol and Salisbury, with the involvement of other relevant trusts. Some aspects of the spoke arrangements are clearly fixed by the commissioning framework, whereas others are negotiable and need to be worked out by the units and approved by the local health authorities as commissioners of the services. It is anticipated within the region's proposals that the follow-up of existing patients will continue at the existing centres, if that is what patients and their families want.
The clear overriding aim is to provide the best quality care and outcomes for children, and I have set out the way in which we intend to achieve that. My view, which is shared by the medical profession generally, is that to use the highly valued skills of surgeons working within multidisciplinary teams in a small number of cleft centres is a proper aim. I hope that I have made it clear that the Department of Health takes very seriously the findings of the CSAG report. We are determined to respond and to secure improvements in the currently unacceptably variable standards of care provided to children. That is as important to the Government as it is to the hon. Gentleman, who has this afternoon rightly voiced the concerns to his constituents.

Question put and agreed to.

Adjourned accordingly at one minute to Three o'clock.